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Costa EM, Pinho JRO, Saraiva MDCP, Ribeiro CCC, Batista RFL, Coêlho Alves CM, Simões VMF, Bettiol H, Barbieri MA, de Carvalho Cavalli R, Thomaz EBAF. RANTES and developmental defects of enamel in children: A Brazilian prenatal cohort (BRISA). PLoS One 2023; 18:e0284606. [PMID: 37498839 PMCID: PMC10374131 DOI: 10.1371/journal.pone.0284606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 04/04/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Little is known about the effect of maternal immunological factors on the etiology of developmental defects of enamel (DDE). RANTES (Regulated on Activation Normal T Cell Expressed and Secreted) is a chemokine produced by fibroblasts, lymphoid and epithelial mucosa cells in response to various external stimuli. Despite its importance for embryogenesis, RANTES expression has been demonstrated in multiple diseases characterized by inflammation, tumor and immune response, and wound healing. We hypothesized that altered levels of RANTES during pregnancy are associated with the immune and inflammatory response in women, which could lead to the occurrence of DDE in utero (DDE-iu), directly or mediated by preterm birth. Therefore, this study aimed to evaluate the direct and indirect effects of serum levels of RANTES in pregnant women in the occurrence of DDE-iu in children. METHODS This is a longitudinal case-control study. The mothers and their children (327) were evaluated in three moments: prenatal care, post childbirth, and when the child was between 12.3 and 36 months of age. The analysis was performed with structural equation modeling, estimating the standardized coefficient (SC), adopting α = 5%. RESULTS There was a direct and negative effect of RANTES on the outcome (SC = -0.137; p = 0.022). This association was not mediated by preterm birth (SC = 0.007; P = 0.551). When considering the specific types of DDE-iu, RANTES had a direct effect on hypoplasia (SC = -0.190; p = 0.007), but not on opacity (SC = 0.343; p = 0.074). CONCLUSION Lower serum levels of RANTES may contribute to a higher number of teeth with DDE-iu, specifically hypoplasia. However, more evidence supported by clinical, laboratory and epidemiological studies is still needed.
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Affiliation(s)
- Elisa Miranda Costa
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | | | - Cecília Cláudia Costa Ribeiro
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Cláudia Maria Coêlho Alves
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Ricardo de Carvalho Cavalli
- Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão, São Paulo, Brazil
| | - Erika Bárbara Abreu Fonseca Thomaz
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
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de Oliveira BR, Magalhães EIDS, Bragança MLBM, Coelho CCNDS, Lima NP, Bettiol H, Barbieri MA, Cardoso VC, dos Santos AM, Horta BL, da Silva AAM. Performance of Body Fat Percentage, Fat Mass Index and Body Mass Index for Detecting Cardiometabolic Outcomes in Brazilian Adults. Nutrients 2023; 15:2974. [PMID: 37447300 PMCID: PMC10346298 DOI: 10.3390/nu15132974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Obesity is a recognized risk factor for the development of cardiometabolic outcomes. Therefore, it is essential to evaluate anthropometric and body composition indicators used for its diagnosis. This study aimed to assess the diagnostic performance of body fat percentage (BF%), fat mass index (FMI) and body mass index (BMI) for detecting cardiometabolic outcomes in adults. A cross-sectional study was conducted involving adults at 30 years of age from Pelotas, RS (n = 3517) and at 37-39 years from Ribeirão Preto, SP (n = 1696). Receiver operating characteristic (ROC) curves were used to determine the cut-off points for predicting cardiometabolic risk factors, including altered blood pressure, blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDDL-c), C-reactive protein and glycated hemoglobin. The cut-off points of BF% ranged from 25.2 to 27.8 in men and from 37.4 to 39.7 in women at 30 years, and from 26.1 to 27.8 in men and from 38.5 to 42.2 in women at 37-39 years. For FMI (kg/m2), the cut-off points ranged from 6.3 to 7.5 in men and from 9.5 to 10.8 in women at 30 years, and from 7.3 to 7.8 in men and from 10.2 to 12.2 in women at 37-39 years. The BMI cut-off points (kg/m2) ranged from 26.3 to 27.3 in men and from 25.4 to 27.2 in women at 30 years, and from 28.3 to 29.0 in men and from 27.2 to 29.6 in women at 37-39 years. The areas under the curve were similar for the three indicators, ranging from 0.523 to 0.746. BMI showed a performance similar to that of the body fat-based indicators in identifying cardiometabolic outcomes. The cut-off points of the three indicators showed acceptable discriminatory power in subjects with cardiometabolic risk factors.
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Affiliation(s)
- Bianca Rodrigues de Oliveira
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Elma Izze da Silva Magalhães
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Maylla Luanna Barbosa Martins Bragança
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Carla Cristine Nascimento da Silva Coelho
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Natália Peixoto Lima
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Heloisa Bettiol
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Marco Antônio Barbieri
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Viviane Cunha Cardoso
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Alcione Miranda dos Santos
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Bernardo Lessa Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Antônio Augusto Moura da Silva
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
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Amorim RV, Barbieri MA, Bôtto-Menezes C, Carmona F, Ferraro AA, Bettiol H. Why are pediatricians uncomfortable with prescribing emergency contraception for adolescents? Rev Paul Pediatr 2023; 41:e2022060. [PMID: 37255109 DOI: 10.1590/1984-0462/2023/41/2022060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/21/2022] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Emergency contraception (EC) is an effective and safe method for preventing unplanned pregnancy after unprotected sexual intercourse among adolescents but is infrequently prescribed by pediatricians. Because of the scarcity of data on the discomfort with EC prescription among physicians in Brazil, this study aimed to identify associated factors with discomfort with EC prescription among pediatricians in the state of Amazonas. METHODS A web-based, cross-sectional study including sociodemographic data, knowledge, attitudes, and discomfort with EC prescription was used. Multivariate logistic regression and artificial intelligence methods such as decision tree and random forest analysis were used to identify factors associated with discomfort with EC prescriptions. RESULTS Among 151 physicians who responded to the survey, 53.0% were uncomfortable with prescribing EC, whereas only 33.1% had already prescribed it. Inexperience was significantly associated with discomfort with EC prescription (odds ratio 4.47, 95% confidence interval 1.71-11.66). Previous EC prescription was protective against discomfort with EC prescription in the three models. CONCLUSIONS EC is still infrequently prescribed by pediatricians because of inexperience and misconceptions. Training these professionals needs to be implemented as part of public health policies to reduce unplanned adolescent pregnancy.
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Affiliation(s)
| | | | - Camila Bôtto-Menezes
- Universidade do Estado do Amazonas, Manaus, AM, Brazil
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil
| | - Fábio Carmona
- Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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de Paula Eduardo JAF, Figueiredo FP, de Rezende MG, da Roza DL, de Freitas SF, Batista RFL, da Silva AAM, Barbieri MA, Carvalho Cavalli R, Bettiol H, Ferraro AA, Del-Ben CM. Preterm birth and postpartum depression within 6 months after childbirth in a Brazilian cohort. Arch Womens Ment Health 2022; 25:929-941. [PMID: 35849216 DOI: 10.1007/s00737-022-01248-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 06/15/2022] [Indexed: 11/26/2022]
Abstract
Preterm birth (PTB) and postpartum depression (PPD) are important public health issues, and although literature mainly supports the association between them, some reviews have highlighted methodological limitations in the studies in this field, restricting the interpretation of such finding. This study aimed at assessing the association between PTB and PPD, by comparing groups of preterm and full-term mothers in two Brazilian cities with contrasting sociodemographic indicators. This prospective convenience cohort study assessed 1421 women during pregnancy, at childbirth, and in the postpartum period. The Edinburgh Postnatal Depression Scale (EPDS) was administrated to assess PPD within 6 months after delivery and women were considered probably depressed if scores were EDPS ≥ 12. PTB was defined as the delivery before 37 completed weeks of pregnancy. A multivariate Poisson regression was used to estimate relative risk for PPD in mothers of preterm infants, and the final analysis models were adjusted for psychosocial variables, selected according to the directed acyclic graph (DAG) approach. Frequencies of PPD were not significantly different in mothers of preterm and full-term infants, in neither city. In the final adjusted model, PTB was not associated with PPD. The association between PTB and PPD was not confirmed in two large samples from two Brazilian cities with contrasting socioeconomic profile. However, maternal health during pregnancy plays an important role in predicting PPD. Prenatal care should promote maternal mental health as an effort towards decreasing unfavored outcomes for mothers, infants, and families.
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Affiliation(s)
| | - Felipe Pinheiro Figueiredo
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Marcos Gonçalves de Rezende
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Daiane Leite da Roza
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Stella Felippe de Freitas
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ricardo Carvalho Cavalli
- Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Cristina Marta Del-Ben
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Barbosa JMA, Ribeiro CCC, Batista RFL, Brondani MA, Simões VMF, Bettiol H, Barbieri MA, Coelho SJDDDAC, Silva AAMD. Behavioral risk factors for noncommunicable diseases associated with depression and suicide risk in adolescence. CAD SAUDE PUBLICA 2022; 38:e00055621. [DOI: 10.1590/0102-311x00055621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/24/2021] [Indexed: 11/22/2022] Open
Abstract
Noncommunicable diseases (NCDs) and mental disorders cooccur in adulthood, which is why their determinants and common risk factors should be addressed at an early age. Therefore, we estimated the association of the major risk factors for NCDs with depression and suicide risk by structural equation modeling considering pathways triggered by social vulnerability or mediated by obesity. This population-based study included 2,515 Brazilian adolescents. The following exposures were the major risk factors for NCDs: substance use behaviors (variable deduced from alcohol, tobacco, and drug use), physical inactivity, and components of unhealthy eating markers (added sugar and saturated fat). Obesity was assessed using the fat mass index. The outcomes were depression and suicide risk. Depression was associated with substance use behaviors (SC = 0.304; p < 0.001), added sugar (SC = 0.094; p = 0.005), and females (SC = 0.310; p < 0.001). Suicide risk was also associated with substance use behaviors (SC = 0.356; p < 0.001), added sugar (SC = 0.100; p = 0.012), and females (SC = 0.207; p < 0.001). In adolescents, these associations may help explain the cluster of NCDs and mental disorders in adulthood.
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Pinto DAS, Nascimento JXPT, Padilha LL, da Conceição SIO, França AKTDC, Simões VMF, Batista RFL, Barbieri MA, Ribeiro CCC. High sugar content and body mass index: modelling pathways around the first 1000 d of life, BRISA cohort. Public Health Nutr 2021; 24:4997-5005. [PMID: 33517949 DOI: 10.1017/s136898002000525x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Few studies are focused on sugar consumption around the first 1000 d of life. Thus, this work modelled the pathways linking the consumption of sugary drinks in pregnancy and maternal pre-gestational BMI to early child’s exposure to products with high sugar content and to BMI z-score in the second year of life. DESIGN BRISA cohort, São Luís, Brazil was used from the baseline to the follow-up at the second year of life. SETTING A theoretical model was constructed to analyse associations between variables from prenatal period (socio-economic status, age, frequency of sugary drinks consumption during pregnancy and pre-gestational BMI), birth weight, exclusive breast-feeding and two outcomes: higher calories from products with added sugar as a percentage of the total daily energy intake and BMI z-score at follow-up at the first 2 years of life, using structural equation modelling. PARTICIPANTS Data of pregnant women (n 1136) and their offspring. RESULTS Higher pre-gestational BMI (standardised coefficient (SC) = 0·100; P = 0·008) and higher frequency of sugary drinks consumption during pregnancy (SC = 0·134; P < 0·001) resulted in high percentage of daily calories from products with added sugar in the second year of child, although no yet effect was observed on offspring weight at that time. CONCLUSIONS Maternal obesity and sugary drinks consumption in pregnancy increased the risk of early exposure (before to 2 years) and high exposure of child to added sugar, showing perpetuation of the unhealthy dietary behaviours in the first 1000 d of life.
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Affiliation(s)
- Dâmaris Alves Silva Pinto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
| | | | - Luana Lopes Padilha
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
| | | | | | - Vanda Maria Ferreira Simões
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
| | - Rosângela Fernandes Lucena Batista
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
| | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Cecilia Claudia Costa Ribeiro
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
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Barbieri MA, Ferraro AA, Simões VMF, Goldani MZ, Cardoso VC, Moura da Silva AA, Bettiol H. Cohort Profile: The 1978-79 Ribeirao Preto (Brazil) birth cohort study. Int J Epidemiol 2021; 51:27-28g. [PMID: 34564724 DOI: 10.1093/ije/dyab190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Marco Antônio Barbieri
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Marcelo Zubaran Goldani
- Department of Pediatrics, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Heloisa Bettiol
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Queiroz RCCDS, Queiroz RCDS, Rocha TAH, Silva FDS, Santos IGD, Silva IPD, Silva NCD, Barbieri MA, Saraiva MDCP, Silva AAMD. Vaccination services and incomplete vaccine coverage for children: a comparative spatial analysis of the BRISA cohorts, São Luís (Maranhão State) and Ribeirão Preto (São Paulo State), Brazil. CAD SAUDE PUBLICA 2021; 37:e00037020. [PMID: 34190749 DOI: 10.1590/0102-311x00037020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/04/2020] [Indexed: 11/22/2022] Open
Abstract
We analyzed the spatial relation between incomplete vaccine coverage for children and the distance from vaccination services. This was a cross-sectional study of children from 13 to 35 months of age from the cities of São Luís (Maranhão State) and Ribeirão Preto (São Paulo State), Brazil, and from basic health units (UBS, in Portuguese). The sample consisted of 2,744 children from São Luís and 3,325 from Ribeirão Preto. Data about incomplete vaccine coverage for children were obtained from the BRISA birth cohorts. Data about the quality of UBS vaccination services were obtained from the first cycle of the Brazilian National Program for Improvement of Access and Quality of Basic Care (PMAQ-AB, in Portuguese). For the spatial analysis, we determined the distance between the residence of the children (with and without a complete vaccine calendar) and the vaccination services of the UBS (classified according to number of structural items). Incomplete vaccine coverage was more pronounced in São Luís, with greater percentages for human rotavirus and triple viral vaccines, with the latter being the least available. In Ribeirão Preto, incomplete BCG vaccine coverage was more pronounced, with the tetravalent vaccine being the least available. Children from the two cities showed similarities: most of them had adult mothers with 9 to 11 years of schooling and did not reside with siblings in the household. They also showed differences: in São Luís, most mothers belonged to the economic class C, while in Ribeirão Preto they belong to the A and B classes. In the two cities with different socioeconomic conditions, complete vaccine coverage seemed not to depend on the location or quality of the vaccination service. Although São Luís showed a better structure of the services, incomplete vaccine coverage was higher compared to Ribeirão Preto.
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Marano M, Rossi F, Ravà L, Khalil Ramla M, Pisani M, Bottari G, Genuini L, Zampini G, Nunziata J, Reale A, Barbieri MA, Celeani F, Di Nardo M, Cecchetti C, Stoppa F, Villani A, Raponi M, Livadiotti S, Pontrelli G. Acute toxic exposures in children: analysis of a three year registry managed by a Pediatric poison control Center in Italy. Ital J Pediatr 2021; 47:125. [PMID: 34078407 PMCID: PMC8170623 DOI: 10.1186/s13052-021-01071-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/14/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Acute pediatric poisoning is an emerging health and social problem. The aim of this study is to describe the characteristics of a large pediatric cohort exposed to xenobiotics, through the analysis of a Pediatric Poison Control Center (PPCc) registry. Methods This study, conducted in the Pediatric Hospital Bambino Gesù of Rome, a reference National Pediatric Hospital, collected data of children whose parents or caregivers contacted the PPCc by phone (group “P”), or who presented to the Emergency Department (group “ED”), during the three-year period 2014–2016. Data were prospectively and systematically collected in a pre-set electronic registry. Comparisons among age groups were performed and multivariable logistic regression models used to investigate associations with outcomes (hospital referral for “P”, and hospital admission for “ED”group). Results We collected data of 1611 children on group P and 1075 on group ED. Both groups were exposed to both pharmaceutical and non-pharmaceutical agents. Pharmaceutical agent exposure increased with age and the most common route of exposure was oral. Only 10% among P group were symptomatic children, with gastrointestinal symptoms. Among the ED patients, 30% were symptomatic children mostly with gastrointestinal (55.4%) and neurologic symptoms (23.8%). Intentional exposure (abuse substance and suicide attempt), which involved 7.7% of patients, was associated with older age and Hospital admission. Conclusions Our study describes the characteristics of xenobiotics exposures in different paediatric age groups, highlighting the impact of both pharmacological and intentional exposure. Furthermore, our study shows the utility of a specific PPCc, either through Phone support or by direct access to ED. PPCc phone counselling could avoid unnecessary access to the ED, a relevant achievement, particularly in the time of a pandemic.
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Affiliation(s)
- M Marano
- DEA Paediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy. .,Paediatric Clinical Toxicology Centre, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy.
| | - F Rossi
- Emergency Department, Children's Hospital Bambino Gesù, IRCCS, Palidoro, Italy
| | - L Ravà
- Epidemiology Unit and Biostatistics, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - M Khalil Ramla
- Paediatric Clinical Toxicology Centre, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - M Pisani
- Emergency Department, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - G Bottari
- DEA Paediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - L Genuini
- DEA Paediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - G Zampini
- DEA Paediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - J Nunziata
- DEA Paediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - A Reale
- Emergency Department, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - M A Barbieri
- Emergency Department, Children's Hospital Bambino Gesù, IRCCS, Palidoro, Italy
| | - F Celeani
- Information Systems Department, General direction Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - M Di Nardo
- DEA Paediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - C Cecchetti
- DEA Paediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - F Stoppa
- DEA Paediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - A Villani
- Emergency Department, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - M Raponi
- Medical Direction, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - S Livadiotti
- Clinical Trials Centre, University Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - G Pontrelli
- Clinical Trials Centre, University Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Barbieri MR, Fontes AM, Barbieri MA, Saraiva MCP, Simões VMF, Silva AAMD, Abraham KJ, Bettiol H. Effects of FTO and PPARγ variants on intrauterine growth restriction in a Brazilian birth cohort. ACTA ACUST UNITED AC 2021; 54:e10465. [PMID: 33729310 PMCID: PMC7945878 DOI: 10.1590/1414-431x202010465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/02/2021] [Indexed: 01/18/2023]
Abstract
Intrauterine growth restriction (IUGR) is related to a higher risk of neonatal mortality, minor cognitive deficit, metabolic syndrome, and cardiovascular disease in adulthood. In previous studies, genetic variants in the FTO (fat mass and obesity-associated) and PPARγ (peroxisome proliferator-activated receptor-gamma) genes have been associated with metabolic disease, body mass index, and obesity among other outcomes. We studied the association of selected FTO (rs1421085, rs55682395, rs17817449, rs8043757, rs9926289, and rs9939609) and PPARγ (rs10865710, rs17036263, rs35206526, rs1801282, rs28763894, rs41516544, rs62243567, rs3856806, and rs1805151) single-nucleotide polymorphisms (SNPs) with IUGR, through a case-control study in a cohort of live births that occurred from June 1978 to May 1979 in a Brazilian city. We selected 280 IUGR cases and 256 controls for analysis. Logistic regression was used to jointly analyze the SNPs as well as factors such as maternal smoking, age, and schooling. We found that the PPARγ rs41516544 increased the risk of IUGR for male offspring (OR 27.83, 95%CI 3.65-212.32) as well as for female offspring (OR=8.94, 95%CI: 1.96-40.88). The FTO rs9939609 TA genotype resulted in a reduced susceptibility to IUGR for male offspring only (OR=0.47, 95%CI: 0.26-0.86). In conclusion, we demonstrated that PPARγ SNP had a positive effect and FTO SNP had a negative effect on IUGR occurrence, and these effects were gender-specific.
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Affiliation(s)
- M R Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A M Fontes
- Departamento de Genética, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M C P Saraiva
- Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Centro de Ciências da Saúde, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A A M da Silva
- Departamento de Saúde Pública, Centro de Ciências da Saúde, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - K J Abraham
- Departamento de Economia, Faculdade de Economia, Administração e Contabilidade de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Fonseca JM, Silva AAM, Rocha PRH, Batista RLF, Thomaz EBAF, Lamy-Filho F, Barbieri MA, Bettiol H. Racial inequality in perinatal outcomes in two Brazilian birth cohorts. ACTA ACUST UNITED AC 2021; 54:e10120. [PMID: 33503156 PMCID: PMC7822460 DOI: 10.1590/1414-431x202010120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/19/2020] [Indexed: 11/25/2022]
Abstract
This study aimed to estimate and compare racial inequality in low birth weight (LBW), preterm birth (PTB), and intrauterine growth restriction (IUGR) in two Brazilian birth cohorts. This was a cross-sectional study nested within two birth cohorts in Ribeirão Preto (RP) and São Luís (SL), whose mothers were interviewed from January to December 2010. In all, 7430 (RP) and 4995 (SL) mothers were interviewed. The maternal skin color was the exposure variable. Associations were adjusted for socioeconomic and biological covariates: maternal education, per capita family income, family economic classification, household head occupation, maternal age, parity, marital status, prenatal care, type of delivery, maternal pre-pregnancy BMI, hypertension, hypertension during pregnancy, and smoking during pregnancy collected from questionnaires applied at birth. Statistical analysis was done with the chi-squared test and logistic regression. In RP, newborns from mothers with black skin color had a higher risk of LBW and IUGR, even after adjusting for socioeconomic and biological variables (P<0.001). In SL, skin color was not a risk factor for LBW (P=0.859), PTB (P=0.220), and IUGR (P=0.062), before or after adjustment for socioeconomic and biological variables. The detection of racial inequality in these perinatal outcomes only in the RP cohort after adjustment for socioeconomic and biological factors may be reflecting the existence of racial discrimination in the RP society. In contrast, the greater miscegenation present in São Luís may be reflecting less racial discrimination of black and brown women in this city.
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Affiliation(s)
- J M Fonseca
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A A M Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - P R H Rocha
- Departamento de Pediatria e Puericultura, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R L F Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - E B A F Thomaz
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - F Lamy-Filho
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - M A Barbieri
- Departamento de Pediatria e Puericultura, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - H Bettiol
- Departamento de Pediatria e Puericultura, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Coelho CCNDS, Bragança MLBM, de Oliveira BR, Bettiol H, Barbieri MA, Cardoso VC, Silva AAMD. Incidence of metabolic syndrome in adults with healthy weight, normal weight obesity, and overweight/obesity. Nutrition 2020; 85:111134. [PMID: 33578242 DOI: 10.1016/j.nut.2020.111134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/01/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study was to estimate the incidence of metabolic syndrome (MetS) in individuals with a healthy weight (HWI), normal weight obesity (NWO), or overweight/obesity (OWO). METHODS In all, 787 adults belonging to a 1978/1979 birth cohort from Ribeirão Preto were placed into one of three groups: HWI (body mass index [BMI] ≥18.5 and <25 kg/m2 + ∑skinfolds ≤90th percentile); NWO (BMI ≥18.5 and <25 kg/m2 +∑skinfolds >90th percentile); and OWO (BMI ≥25 kg/m2 +∑skinfolds >90th percentile). Those diagnosed with MetS at the 23 to 25 y of age were excluded according to Joint Interim Statement criteria. The incidence of MetS and its components in individuals 37 to 39 y of age was evaluated by Poisson regression with robust estimation of variance, which was adjusted for family income; physical activity level; and daily intake of calories, lipids, and added sugar. RESULTS MetS was detected in 279 adults at 37 to 39 y of age. NWO and OWO individuals showed higher risk ratios (RRs) for the development of MetS (RR,1.87; 95% confidence interval [CI], 1.36-2.57; RR, 1.61; 95% CI, 1.29-2.03), increased blood glucose levels (RR, 1.77; 95% CI, 1.12-2.79; RR, 1.51; 95% CI, 1.12-2.04), and increased waist circumferences (RR, 1.46; 95% CI, 1.32-1.61; RR, 1.50; 95% CI, 1.38-1.62). There was a higher risk for increased blood pressure (RR, 1.72; 95% CI, 1.35-2.19) among OWO individuals, but not among those with NWO. CONCLUSION Individuals with NWO have a risk ratio for MetS similar to individuals with OWO. This demonstrates the need to assess body fat percentages, even in BMI-designated normal weight individuals, both for prevention and management of obesity.
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Affiliation(s)
| | | | - Bianca Rodrigues de Oliveira
- Postgraduation Program of Collective Health, Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Viviane Cunha Cardoso
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Antônio Augusto Moura da Silva
- Postgraduation Program of Collective Health, Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Bogea EG, França AKTC, Bragança MLBM, Vaz JS, Assunção MC, Barbieri MA, Bettiol H, Silva AAM. Relative validity of a food frequency questionnaire for adolescents from a capital in the Northeastern region of Brazil. ACTA ACUST UNITED AC 2020; 54:e9991. [PMID: 33338101 PMCID: PMC7747872 DOI: 10.1590/1414-431x20209991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/26/2020] [Indexed: 11/25/2022]
Abstract
The present study was conducted to evaluate the validity of the Food Frequency
Questionnaire (FFQ) used in the RPS Birth Cohort Consortium (Ribeirão Preto,
Pelotas, and São Luís) to assess dietary intake of adolescents from São Luís,
Maranhão. The research was developed with 152 adolescents aged 18 and 19 years.
For the validation of the FFQ, the average of three 24-hour recalls (24HRs) was
used as the reference method. The mean and standard deviation of energy and
nutrient intake extracted from the surveys were estimated. The paired Student's
t-test was used to verify the differences between the
instruments. Pearson correlation coefficient, intraclass correlation coefficient
(ICC), weighted Kappa, and the Bland-Altman plot were calculated in order to
measure the agreement. The study adopted a level of significance <5%.
Compared with the three 24HRs, the FFQ overestimated the consumption of most
nutrients. Energy-adjusted and de-attenuated concordance Pearson correlation
coefficients ranged from 0.06 to 0.43, and correlations were significant for
iron, calcium, riboflavin, sodium, saturated fat, niacin, and vitamin C. The
energy-adjusted and de-attenuated ICCs ranged from 0.01 to 0.31, and the
weighted Kappa ranged from 0.01 to 0.46. The analyses of agreement were
significant for vitamin C, fiber, calcium, riboflavin, niacin, sodium, lipids,
and iron. In conclusion, the FFQ presented acceptable relative validity for
lipids, saturated fatty acids, fiber, calcium, iron, riboflavin, niacin, vitamin
C, and sodium. This instrument will be useful in studies about food consumption
of adolescents in São Luís, Maranhão.
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Affiliation(s)
- E G Bogea
- Centro de Ciências Biológicas e da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A K T C França
- Centro de Ciências Biológicas e da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - M L B M Bragança
- Centro de Ciências Biológicas e da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - J S Vaz
- Faculdade de Nutrição, Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - M C Assunção
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil.,Programa de Pós-Graduação em Saúde Pública, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A A M Silva
- Centro de Ciências Biológicas e da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brasil
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Bernardo FMM, Veiga ECA, Quintana SM, Camayo FJA, Batista RFL, Alves MTSSB, Bettiol H, Barbieri MA, Cardoso VC, Cavalli RC. Association of genitourinary infections and cervical length with preterm childbirth. ACTA ACUST UNITED AC 2020; 54:e10235. [PMID: 33338099 PMCID: PMC7747871 DOI: 10.1590/1414-431x202010235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/28/2020] [Indexed: 11/21/2022]
Abstract
A prospective cohort study was conducted on a convenience sample of 1370 pregnant
women with a gestational age of 20 to 25 weeks in the city of Ribeirão Preto.
Data on obstetrical history, maternal age, parity, smoking habit, and a history
of preterm delivery was collected with the application of a sociodemographic
questionnaire. Cervical length was determined by endovaginal ultrasound, and
urine and vaginal content samples were obtained to determine urinary tract
infection (UTI) and bacterial vaginosis (BV), respectively. The aim of this
study was to verify the association of cervical length and genitourinary
infections with preterm birth (PTB). Ultrasound showed no association of UTI or
BV with short cervical length. PTB rate was 9.63%. Among the women with PTB, 15
showed UTI (RR: 1.55, 95%CI: 0.93–2.58), 19 had BV (RR: 1.22, 95%CI: 0.77–1.94),
and one had both UTI and BV (RR: 0.85, 95%CI: 0.13–5.62). Nineteen (14.4%) PTB
occurred in women with a cervical length ≤2.5 cm (RR: 2.89, 95%CI: 1.89–4.43).
Among the 75 patients with PTB stratified as spontaneous, 10 showed UTI (RR:
2.02, 95%CI: 1.05–3.86) and 14 had a diagnosis of BV (RR: 1.72, 95%CI:
0.97–3.04). A short cervical length between 20 and 25 weeks of pregnancy was
associated with PTB, whereas UTI and BV determined at this age were not
associated with short cervical length or with PTB, although UTI, even if
asymptomatic, was related to spontaneous PTB.
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Affiliation(s)
- F M M Bernardo
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - E C A Veiga
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - S M Quintana
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - F J A Camayo
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - M T S S B Alves
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R C Cavalli
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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15
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Negrão MEA, Rocha PRH, Saraiva MCP, Barbieri MA, Simões VMF, Batista RFL, Ferraro AA, Bettiol H. Association between tobacco and/or alcohol consumption during pregnancy and infant development: BRISA Cohort. ACTA ACUST UNITED AC 2020; 54:10252-0. [PMID: 33338100 PMCID: PMC7780373 DOI: 10.1590/1414-431x202010252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/28/2020] [Indexed: 01/13/2023]
Abstract
Fetuses exposed to alcohol and/or tobacco are at risk for perinatal adversities.
However, little is currently known about the association of the separate or
concomitant use of alcohol and tobacco with infant motor and cognitive
development. Thus, the objective of the present study was to investigate the
association between maternal consumption of alcohol and/or tobacco during
pregnancy and the motor and cognitive development of children starting from the
second year of life. The study included 1006 children of a cohort started during
the prenatal period (22-25 weeks of pregnancy), evaluated at birth and
reevaluated during the second year of life in 2011/2013. The children were
divided into four groups according to the alcohol and/or tobacco consumption
reported by their mothers at childbirth: no consumption (NC), separate alcohol
consumption (AC), separate tobacco consumption (TC), and concomitant use of both
(ACTC). The Bayley Scale of Infant and Toddler Development Third Edition
screening tool was used for the assessment of motor and cognitive development.
Adjusted Poisson regression models were used to determine the association
between groups and delayed development. The results indicated that only the ACTC
group showed a higher risk of motor delay, specifically regarding fine motor
skills, compared to the NC group (RR=2.81; 95%CI: 1.65; 4.77). Separate alcohol
or tobacco consumption was not associated with delayed gross motor or cognitive
development. However, the concomitant use of the two substances increased the
risk of delayed acquisition of fine motor skills.
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Affiliation(s)
- M E A Negrão
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - P R H Rocha
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M C P Saraiva
- Departamento de Clínica Infantil, Faculdade de Odontologia Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A A Ferraro
- Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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16
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Cavalcante MCV, Lamy ZC, França AKTC, Pereira MUL, Ferraro AA, Barbieri MA, Lamy-Filho F. Psychological distress and mother-child relationship: influence of life context on a population sample (BRISA) through the use of directed acyclic graphs (DAG). ACTA ACUST UNITED AC 2020; 54:e10080. [PMID: 33295535 PMCID: PMC7727100 DOI: 10.1590/1414-431x202010080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 10/22/2020] [Indexed: 11/21/2022]
Abstract
This study aimed to investigate the association between maternal psychological distress and impairment in mother-child relationship in a sample from a Northeast capital city in Brazil with a low Human Development Index, using directed acyclic graphs (DAG). A total of 3,215 women were evaluated for the presence of psychological distress through the Self Reporting Questionnaire instrument and for the mother-child relationship by the first factor of Postpartum Bonding Questionnaire, considered the most appropriate in the literature. Demographic and socioeconomic variables were used to construct a theoretical model and, after this, multivariate logistic regression was performed using variables suggested by Directed Acyclic Graphs (DAG). Psychological distress was present in 22.7% of the women and 12.6% of them presented impaired mother-child relationships. After adjustment, the variable 'maternal mental distress' remained associated with impaired mother-child relationship (RR=3.03), and among the explanatory variables only 'primary school level' (RR=1.48) was associated as a risk factor to this outcome. The results indicated that, in this population, women with psychological distress and lower schooling are more likely to present impaired mother-child relationships.
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Affiliation(s)
- M C V Cavalcante
- Hospital Universitário, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - Z C Lamy
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A K T C França
- Departamento de Ciências Fisiológicas, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - M U L Pereira
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil.,Departamento de Saúde Coletiva, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - A A Ferraro
- Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - F Lamy-Filho
- Departamento de Medicina III, Universidade Federal do Maranhão, São Luís, MA, Brasil
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17
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Soares ALFH, Ribeiro CCC, Thomaz EBAF, Queiroz RCS, Alves CMC, Ferraro AA, Silva AAM, Bettiol H, Barbieri MA, Saraiva MCP. Socio-environmental determinants of the delay in the first dental visit: results of two population-based cohort studies in Brazil. ACTA ACUST UNITED AC 2020; 54:e10161. [PMID: 33263609 PMCID: PMC7695448 DOI: 10.1590/1414-431x202010161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/24/2020] [Indexed: 12/01/2022]
Abstract
The objective of this study was to describe the timing of the first dental visit and investigate the association of socioeconomic and behavioral factors with dental visit delay among 10/11-year-old children from two live-birth population cohorts with extremely contrasting socioeconomic profiles. Follow-up data (2004-2005) from cohorts of Ribeirão Preto (RP) (n=790) and São Luís (SL) (n=673) were evaluated. Delay in dental visit was defined as not visiting a dentist before the age of 7. Covariates included family socioeconomic characteristics, mother-related health behavior, and child-related characteristics. Prevalence ratios with robust standard errors were estimated. In both cohorts, less than 5% of children had visited a dentist before the age of two and about 35% of them had not visited a dentist before the age of seven. Lower mother’s schooling and lack of private health insurance were associated with the delay in first dental visit for both cohorts. A small number of mother's prenatal care visits and being from a single-father family or a family without parents were only associated in the RP cohort, while having ≥4 siblings and lifetime dental pain were associated in the SL cohort. The association with dental pain probably reveals a preventive care-seeking behavior. Therefore, the percentage of delayed first dental visit of children was very high even among those with the most educated mothers. Further studies are necessary to analyze recent changes and underlying factors related to access to first dental visit after the implementation of the National Oral Health Policy in 2006.
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Affiliation(s)
- A L F H Soares
- Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C C C Ribeiro
- Departamento de Odontologia II, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - E B A F Thomaz
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R C S Queiroz
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - C M C Alves
- Departamento de Odontologia II, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A A Ferraro
- Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - A A M Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M C P Saraiva
- Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Martins LAB, Veiga ECA, Ribeiro CCC, Simões VMF, Cardoso VC, Bettiol H, Barbieri MA, Cavalli RC. Uterine vascular resistance and other maternal factors associated with the risk of developing hypertension during pregnancy. ACTA ACUST UNITED AC 2020; 54:e10118. [PMID: 33237124 PMCID: PMC7679108 DOI: 10.1590/1414-431x202010118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/27/2020] [Indexed: 11/22/2022]
Abstract
Gestational hypertension and pre-eclampsia are important causes of perinatal morbidity. The objective of the present study was to determine the increase in relative risk for developing hypertensive disorders of pregnancy based on the evaluation of pregnant women between 20 and 25 weeks of gestation, and to correlate the findings at this period with the outcome of pregnancy. We conducted a prospective cohort study, with a convenience sample of 1417 patients evaluated at this gestational age, of which 1306 were contacted at childbirth. We detected an increased relative risk of 2.69 (95%CI: 1.86 to 3.89) associated with pulsatility index of the uterine arteries, a 2.8 increase (95%CI: 1.58 to 5.03) in relative risk attributed to maternal age above 35 years, a 1.68 increase (95%CI: 1.17 to 2.40) attributed to parity greater than or equal to 3, and a 5.35 increase (95%CI: 4.18 to 6.85) attributed to chronic hypertension and obesity, with a progressive increase in relative risk according to the degree of overweight, i.e., grades 1, 2, 3, and morbid obesity (2.58, 3.06, 5.84, and 7.28, respectively).
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Affiliation(s)
- L A B Martins
- Faculdade de Ciências da Saúde de Barretos Dr. Paulo Prata, Barretos, SP, Brasil
| | - E C A Veiga
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C C C Ribeiro
- Departamento de Odontologia II, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R C Cavalli
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Zhang W, Veisaga ML, Barbieri MA. Role of RIN1 on telomerase activity driven by EGF-Ras mediated signaling in breast cancer. Exp Cell Res 2020; 396:112318. [PMID: 33069695 DOI: 10.1016/j.yexcr.2020.112318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 11/27/2022]
Abstract
Epidermal growth factor (EGF)-receptor regulates several downstream signaling pathways upon EGF stimulation that involves cell proliferation, migration and invasion. Internalized EGF-receptor is either recycled or degraded, which fate is regulated in part by Ras interference 1 (RIN1). In this study, we tested the hypothesis that RIN1, a Ras effector protein and Rab5 guanine nucleotide exchange factor, controls several signaling molecules leading to the modulation of the telomerase activity; thus, allowing proper cell proliferation. We report that expression of RIN1 completely blocked proliferation of MCF-12 A and MCF-7 cells, while partially inhibited proliferation of MDA-MB-231 cells upon EGF stimulation. Furthermore, expression of the C-terminal region of RIN1 selectively plays a critical role in the inhibition of the proliferation of MDA-MB-231 cells. However, this inhibitory effect was specifically affected by the independent expression of RIN1:Vsp9 and RIN1:RA domains. Additionally, endogenous level of expression of RIN1 was decreased in metastatic MDA-MB-231 cells as compared with non-tumorigenic MCF-12 A cells. We observed that expression of RIN1:R94A mutant blocked the proliferation of MDA-MB-231 cells, while expression of RIN1:Y561F and RIN1:R629A mutants completely reversed the inhibitory effect of RIN1:WT. Consistent with our observations, we found that expression of RIN1:WT in MDA-MB-231 cells diminished both protein kinase B (AKT) and extracellular-signal-regulated kinase 1/2 (ERK1/2) activities while p38 mitogen-activated protein kinases (p38 MAPK) and stress-activated protein kinase (SAPK)/c-Jun N-terminal kinase (JNK) were unaffected, but it produced downregulation of cellular-myelocytomatosis (c-Myc), erythroblast transformation specific (Ets2) and signal transducer and activator of transcription 3 (Stat3) activities. Inversely, expression of high-mobility group box 1 (HMBG1) was inhibited whereas expression of forkhead box transcription factor 1 (FOXO1) was increased in cells expressing RIN1. Interestingly, expression of RIN1 blocked telomerase activity and human telomerase reverse transcriptase (hTERT) expression, which correlated with the downregulations of c-Myc, Ets-2 and Stat3 activation. Taken together these findings indicate that RIN1 is a critical player in the modulation of the telomerase activity as well as hTERT expression in MDA-MB-231 cells upon EGF stimulation.
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Affiliation(s)
- W Zhang
- Biochemistry PhD Program, Florida International University, 11220 SW 8th Street, Miami, FL, 33199, USA
| | - M L Veisaga
- Biomolecular Sciences Institute, Florida International University, 11220 SW 8th Street, Miami, FL, 33199, USA
| | - M A Barbieri
- Department of Biological Sciences, Florida International University, 11220 SW 8th Street, Miami, FL, 33199, USA; Biomolecular Sciences Institute, Florida International University, 11220 SW 8th Street, Miami, FL, 33199, USA; Fairchild Tropical Botanic Garden, 10901 Old Cutler Road, Coral Gables, FL, 33156, USA; International Center of Tropical Botany, Florida International University, 11220 SW 8th Street, Miami, FL, 33199, USA.
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20
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de Oliveira BR, Bragança MLBM, Batalha MA, Coelho CCNDS, Bettiol H, Barbieri MA, Saraiva MDCP, Kac G, da Silva AAM. Diagnostic performance of body mass index in detection of obesity using different cutoff points for excess body fat. Nutrition 2020; 79-80:110950. [PMID: 32836176 DOI: 10.1016/j.nut.2020.110950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/05/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to assess the diagnostic sensitivity of body mass index (BMI) in detecting obesity according to different cutoff points in order to classify a high body fat percentage (%BF) in adolescents and young adults. METHODS This was a cross-sectional study conducted with 2447 adolescents 18 and 19 y of age residing in São Luís, Brazil and 951 young adults 21 to 23 y of age residing in Ribeirão Preto, Brazil. Three references were used to define a high %BF (i.e., those of Williams et al., Ramírez-Vélez et al., and Macias et al.). The area under the receiver operating characteristic area under the curve (AUC) was used to assess the performance of BMI. RESULTS Sensitivity ranged from 38.3% to 54.1% among boys and from 12.7% to 72.7% among girls. Among young adults, it ranged from 52.3% to 67.1% in men and from 33.7% to 86.6% in women. The AUC ranged from 0.69 to 0.76 among boys, from 0.56 from 0.85 among girls, from 0.75 to 0.80 among men, and from 0.67 to 0.88 among women. The best cutoff points for the BMI were 24.79 to 25.10 kg/m2 for boys, 21.89 to 27.04 kg/m2 for girls, 26.43 to 28.22 kg/m2 for men, and 23.34 to 29.28 kg/m2 for women. CONCLUSION The use of different references for the classification of a high %BF implied a difference in the diagnostic sensitivity of the BMI. Higher cutoff points resulted in greater sensitivity and ability to differentiate individuals with and without obesity.
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Affiliation(s)
- Bianca Rodrigues de Oliveira
- Postgraduation Program of Collective Health, Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil.
| | | | - Mônica Araújo Batalha
- Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Gilberto Kac
- Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Antônio Augusto Moura da Silva
- Postgraduation Program of Collective Health, Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
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21
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Vieira CS, Braga GC, Cruz Lugarinho PT, Stifani BM, Bettiol H, Barbieri MA, Cardoso VC, de Carvalho Cavalli R. Sociodemographic factors and prenatal care behaviors associated with unplanned pregnancy in a Brazilian birth cohort study. Int J Gynaecol Obstet 2020; 151:237-243. [PMID: 32652559 DOI: 10.1002/ijgo.13305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/23/2020] [Accepted: 07/08/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To identify the sociodemographic factors and prenatal behavior characteristics associated with unplanned pregnancy. METHODS A cross-sectional survey was conducted of mothers of newborns enrolled in a birth cohort in Ribeirão Preto, Brazil. Questionnaires were administered to postpartum women. Multiple logistic regression was used to identify sociodemographic predictors of unplanned pregnancy and to evaluate the association with adherence to prenatal care recommendations. RESULTS The cohort included 7608 mothers: 7541 (99.1%) answered the interview and 4056 (53.8%) had an unplanned pregnancy. Adolescents were more likely to have an unplanned pregnancy (odds ratio [OR] 1.87; 95% confidence interval [CI] 1.50-2.34) as were women over 40 (OR 1.74; 95% CI 1.22-2.47). Pregnancy during adolescence (OR 1.27; 95% CI 1.09-1.48), being single (OR 7.56; 95% CI 5.98-9.56), having two or more previous births (OR 1.73; 95% CI 1.52-1.97), and being of a lower socioeconomic status were also predictors. Lack or late initiation of prenatal care, attendance at less than six prenatal visits, drinking alcohol, and smoking during pregnancy were associated with unplanned pregnancy. CONCLUSION Unplanned pregnancies disproportionately affect women at extremes of age, single, and of low socioeconomic status. These women are less likely to adhere to prenatal care.
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Affiliation(s)
- Carolina Sales Vieira
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Giordana Campos Braga
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Bianca Maria Stifani
- Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Heloisa Bettiol
- Department of Pediatrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Marco Antônio Barbieri
- Department of Pediatrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ricardo de Carvalho Cavalli
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Souza MCO, Saraiva MCP, Honda M, Barbieri MA, Bettiol H, Barbosa F, Kannan K. Exposure to per- and polyfluorinated alkyl substances in pregnant Brazilian women and its association with fetal growth. Environ Res 2020; 187:109585. [PMID: 32442788 DOI: 10.1016/j.envres.2020.109585] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
Research pertaining to exposure of humans to per- and polyfluorinated alkyl substances (PFASs) has received considerable public and regulatory attention in recent years. Although several studies have reported exposure to PFASs by populations in North America and western Europe, such information is still scarce in Latin America, including Brazil. In this study, concentrations of thirteen PFASs were determined in whole blood collected during the second trimester from 252 pregnant Brazilian women. This is a nested case-control study within the Brazilian Ribeirao Preto and Sao Luiz Birth Cohort Study (BRISA) with selected birth outcomes cases (n = 63) and matched controls (n = 189). PFASs concentrations were associated with conditions including preeclampsia, birth weight (BW), preterm birth, and intrauterine growth restriction (IUGR). Among PFASs measured, perfluorooctane sulfonate (PFOS) was found at the highest concentration (range: 1.06-106 ng mL-1 with a median value of 3.41 ng mL-1) which was followed by perfluorooctanoic acid (PFOA, range: 0.11-2.77 ng mL-1 with a median value of 0.20 ng mL-1). A significant positive association of PFOS and PFOA concentrations with fetal growth restriction (p < 0.05) was found. This is the first study to assess whole blood concentrations of PFASs and their effect on fetal growth in pregnant Brazilian women.
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Affiliation(s)
- Marilia Cristina Oliveira Souza
- Laboratório de Toxicologia Analítica e de Sistemas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, 14040-903, Brazil; Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, 10016, USA.
| | - Maria Conceição Pereira Saraiva
- Departamento de Clinica Infantil, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Masato Honda
- Institute of Nature and Environmental Technology, Kanazawa University, Kakuma, Kanazawa, Ishikawa Prefecture, 920-119, Japan; Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, 10016, USA
| | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brazil
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brazil
| | - Fernando Barbosa
- Laboratório de Toxicologia Analítica e de Sistemas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, 14040-903, Brazil.
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, 10016, USA; Biochemistry Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
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Amaral MS, Ribeiro CCC, Alves MTSDBE, Ribeiro MJS, Nascimento JXPT, Simões VMF, Ferraro AA, Barbieri MA, Silva AAMD. Modeling Pathways From the Perinatal Factors to the Vascular Risk Phenotype at the End of the Second Decade of Life: Birth Cohort, Brazil. Hypertension 2020; 76:359-365. [PMID: 32594805 DOI: 10.1161/hypertensionaha.119.14218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Risk factors act around birth increasing future vascular risk. In this study, we analysed the pathways from perinatal factors to the vascular risk phenotype (VRP) in adolescents including indirect pathways mediated by obesity in adolescence. Data from a Brazilian cohort were collected at birth and at 18 to 19 years (follow-up). A theoretical model was constructed to analyze the association between variables at birth (socioeconomic status, prepregnancy body mass index, mother's age, history of maternal hypertension, maternal smoking, gestational age at birth, birth weight, sex, delivery type) and at follow-up (smoking and excess weight) with the VRP, using structural equation modeling. VRP was a continuous latent variable, representing the shared variance of blood pressure indictors and carotid-femoral pulse wave velocity. Males had higher VRP (standardized coefficient [SC], 0.561; P<0.001). Higher prepregnancy body mass index was associated with higher VRP (SC, 0.140; P=0.032). Gestational age <34 weeks had a total (SC, 0.259; P=0.002) and direct effect (SC, 0.354; P=0.018) on VRP. Cesarean delivery had a total effect, albeit borderline, on VRP (SC, 0.159; P=0.066). Excess weight at follow-up was the main determinant of a high VRP (SC, 0.470; P<0.001). Male sex, cesarean section, gestational age <34 weeks, pregestational excess weight, and excess weight in adolescents were associated with increased VRP at 18 to 19 years of age.
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Affiliation(s)
- Marconi Satuf Amaral
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil
| | - Cecilia Claudia Costa Ribeiro
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil.,Dentistry Department (C.C.C.R.), Federal University of Maranhão, São Luís, Brazil
| | - Maria Teresa Seabra de Britto E Alves
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil
| | | | | | - Vanda Maria Ferreira Simões
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil
| | - Alexandre Archanjo Ferraro
- Department of Pediatrics, University of São Paulo School of Medicine, University of São Paulo, Brazil (A.A.F.)
| | - Marco Antônio Barbieri
- Faculty of Medicine of Ribeirão Preto, São Paulo University, Department of Puericulture and Pediatrics, Ribeirão Preto, Brazil (M.A.B.)
| | - Antônio Augusto Moura da Silva
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil
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Padilha LL, Ribeiro CCC, Nascimento JXPT, Simões VMF, Vitti FP, Cardoso VC, Vianna EO, Barbieri MA, Silva AAMD, Bettiol H. Lifetime overweight and adult asthma: 1978/1979 Ribeirão Preto Birth Cohort, São Paulo, Brazil. CAD SAUDE PUBLICA 2020; 36:e00041519. [PMID: 32187287 DOI: 10.1590/0102-311x00041519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 08/23/2019] [Indexed: 11/22/2022] Open
Abstract
Studies focusing on obesity and asthma frequently consider the weight at a given time; thus, modeling pathways through lifetime overweight may contribute to elucidate temporal aspects in this relationship. This study modeled the pathways in the association of lifetime overweight with asthma in adult life, using data from the 1978/1979 Birth Cohort, Ribeirão Preto, São Paulo, Brazil (n = 2,063) at birth (baseline), school age (9/11 years) and adult age (23/25 years). A theoretical model was proposed to explore the effects of lifetime overweight on asthma in adult life analyzed by structural equation modeling. Parental obesity (SC - standardized coefficenttotal = 0.211, p < 0.001; SCdirect = 0.115, p = 0.007) and overweight at school age (SCtotal = 0.565, p < 0.0001; SCdirect = 0.565, p < 0.0001) were associated with overweight in adult life. Parental obesity (SCdirect = 0.105, p = 0.047) and nutritional status at birth (SCtotal = -0.124, p = 0.009; SCdirect = -0.131, p = 0.007) were associated with asthma in adult life. A higher "current adult socieconomic situation" was inversely associated to overweight (SCdirect = -0.171, p = 0.020) and to asthma in adult life (SCtotal = -0.179, p = 0.041; SCdirect = -0.182, p = 0.039). Parental obesity showed a transgenerational effect in weight, triggering to childhood and adulthood overweight. Parallel to underweight at birth, parental obesity was also a risk to asthma in adult life. While, the socioeconomic status in adult life protected from both, overweight and asthma.
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Affiliation(s)
| | | | | | | | - Fernanda Pino Vitti
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Elcio Oliveira Vianna
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Marco Antônio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - Heloísa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
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25
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Okido MM, Bettiol H, Barbieri MA, Marcolin AC, Quintana SM, Cardoso VC, Del-Ben CM, Cavalli RC. Can increased resistance to uterine artery flow be a risk factor for adverse neurodevelopmental outcomes in childhood? A prospective cohort study. J OBSTET GYNAECOL 2019; 40:784-791. [PMID: 31790313 DOI: 10.1080/01443615.2019.1666094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A prospective cohort study was conducted to determine whether an increased uterine artery pulsatility index (UtA-PI) in the second trimester of pregnancy is a risk factor for neurodevelopmental outcomes in children 2-3 years of age. A group of pregnant women with a UtA-PI below the 90th percentile (P90) and a second group with a UtA-PI ≥ P90 in the second trimester were included in this study. The children of these women were evaluated during their second or third year of life using the Bayley III Screening Test. A total of 858 pregnancies with UtA-PI < P90 and 96 pregnancies with UtA-PI ≥ 90 were studied. The differences between the groups related to UtA-PI ≥ 90 were detected in relation to the variables of the Caucasian ethnicity, hypertension, newborn weight and stay in the intensive care unit after birth. However, adjusted neurodevelopmental outcomes did not differ between the groups: OR 0.53 (95% CI 0.27-1.04%). This study failed to demonstrate that the UtA-PI is a risk factor for adverse neurodevelopment in children.Impact statementWhat is already known on this subject? Early interventions in children at high risk for neurodevelopmental deficiency have proved to be beneficial. The complications associated with gestation and delivery negatively influence neurodevelopment. Several studies have shown that some adverse pregnancy outcomes such as preeclampsia, foetal growth restriction and foetal death can be predicted by increased resistance to flow in the uterine artery in the second trimester. However, there are no studies evaluating the association of the uterine artery with neurodevelopmental results.What do the results of this study add? This study concludes that neurodevelopment is influenced by multiple environmental and intrinsic factors and cannot be predicted by only one variable, such as the uterine artery blood flow. The brain has repair mechanisms to attenuate insults that occur during gestation and delivery.What are the implications of these findings for clinical practice and/or further research? This study was unable to demonstrate that blood flow in the uterine artery is a risk factor for neurodevelopment. Different, larger studies should be conducted by combining other factors with the uterine artery in an algorithm to allow the early identification of children at risk for neurodevelopmental impairment.
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Affiliation(s)
- M M Okido
- Department of Obstetrics and Gynaecology, University of São Paulo, Ribeirão Preto, Brazil
| | - H Bettiol
- Department of Puericulture and Pediatrics, University of São Paulo, Ribeirão Preto, Brazil
| | - M A Barbieri
- Department of Puericulture and Pediatrics, University of São Paulo, Ribeirão Preto, Brazil
| | - A C Marcolin
- Department of Obstetrics and Gynaecology, University of São Paulo, Ribeirão Preto, Brazil
| | - S M Quintana
- Department of Obstetrics and Gynaecology, University of São Paulo, Ribeirão Preto, Brazil
| | - V C Cardoso
- Department of Puericulture and Pediatrics, University of São Paulo, Ribeirão Preto, Brazil
| | - C M Del-Ben
- Department of Neurology, Psychiatry and Medical Psychology, University of São Paulo, Ribeirão Preto, Brazil
| | - R C Cavalli
- Department of Obstetrics and Gynaecology, University of São Paulo, Ribeirão Preto, Brazil
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26
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Costa EM, de Araujo Figueiredo CS, Martins RFM, Ribeiro CCC, Alves CMC, Sesso MLT, Nogueira RD, da Conceição Saraiva M, Barbieri MA, Bettiol H, da Silva AAM, Thomaz EBAF. Periodontopathogenic microbiota, infectious mechanisms and preterm birth: analysis with structural equations (cohort-BRISA). Arch Gynecol Obstet 2019; 300:1521-1530. [PMID: 31677089 DOI: 10.1007/s00404-019-05355-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/18/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE The association between periodontopathogenic microbiota and preterm birth (PTB) has been overly studied. However, the biological mechanisms involved are little known. The objective is to evaluate the effect of periodontopathogenic bacteria burden (PBB), periodontal disease and other infections during pregnancy on preterm birth (PTB), through Structural Equation Modeling. METHODS This was a case-control study nested in a prospective cohort called BRISA, including 330 pregnant women, 110 cases and 220 controls. This study included the following variables: cytokines interleukin-10 (IL-10) and transforming growth factor beta (TGF-β), periodontal disease, PBB, age, socioeconomic status (SES), systemic infections and PTB. The correlations between variables were analyzed using Standardized Coefficient (SC). RESULTS Greater PBB interfered positively with the occurrence of periodontal disease (SC: 0.027; p: 0.011), but these were not associated with the cytokines studied, nor with PTB. The lower serum levels of IL-10 (SC - 0.330; p 0.022) and TGF-β (SC - 0.612; p < 0.001), and the presence of other systemic infections during pregnancy (SC 0.159; 0.049) explained the higher occurrence of PTB. CONCLUSION It is possible that only the more severe periodontal disease and other systemic infections are capable of altering the cascade of cytokines regulating the inflammatory process and have an effect on the occurrence of PTB.
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Affiliation(s)
- Elisa Miranda Costa
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil.
| | | | - Rafiza Félix Marão Martins
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil
| | - Cecília Claudia Costa Ribeiro
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil.,Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Claudia Maria Coelho Alves
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil.,Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Maria Lúcia Talarico Sesso
- Department of Pediatrics, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Maria da Conceição Saraiva
- Department of Pediatrics and Social Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Augusto Moura da Silva
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil
| | - Erika Bárbara Abreu Fonseca Thomaz
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil.,Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Ferraro AA, Barbieri MA, da Silva AAM, Goldani MZ, Fernandes MTB, Cardoso VC, Stein AD, Bettiol H. Cesarean Delivery and Hypertension in Early Adulthood. Am J Epidemiol 2019; 188:1296-1303. [PMID: 31111861 DOI: 10.1093/aje/kwz096] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 12/17/2022] Open
Abstract
The rate of cesarean delivery (CD) is high in many parts of the world. Birth via CD has been associated with adverse later health outcomes, such as obesity, asthma, and type 1 diabetes mellitus. Few studies have focused on hypertension. We investigated the associations of CD with hypertension, systolic blood pressure (BP), and diastolic BP and tested whether body mass index (BMI; weight (kg)/height (m)2) was a mediator of these associations in a birth cohort (n = 2,020) assembled in 1978-1979 and followed up in 2002-2004 in Ribeirão Preto, Brazil. The CD rate was 32.0%. Hypertension was present in 11.7% of persons born via CD and 7.7% of those born vaginally. Being born by CD increased the odds of hypertension by 51% (odds ratio = 1.51, 95% confidence interval (CI): 1.10, 2.07). After adjustment for confounders, this estimate changed little (odds ratio = 1.49, 95% CI: 1.07, 2.06). In a mediation analysis, odds ratios for the indirect and direct effects were 1.18 (95% CI: 1.11, 1.25) and 1.31 (95% CI: 0.97, 1.65), respectively. CD also had indirect effects on both systolic and diastolic BP via BMI. Our findings suggest that CD is associated with young-adult hypertension and that this association is at least partially mediated by BMI. This has implications for countries struggling with the burden of noncommunicable diseases and where CD rates are high.
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Affiliation(s)
| | - Marco Antônio Barbieri
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Marcelo Zubaran Goldani
- Department of Pediatrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Viviane Cunha Cardoso
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Aryeh David Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Heloisa Bettiol
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Moraes LMVD, Simões VMF, Carvalho CDA, Batista RFL, Alves MTSSDBE, Thomaz ÉBAF, Barbieri MA, Alves CMC. [Factors associated with the involuntary pilgrimage for childbirth care in São Luís (Maranhão State) and Ribeirão Preto (São Paulo State), Brazil: a contribution from the BRISA cohort]. CAD SAUDE PUBLICA 2018; 34:e00151217. [PMID: 30427413 DOI: 10.1590/0102-311x00151217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 06/13/2018] [Indexed: 11/22/2022] Open
Abstract
The objectives of this study were to estimate the involuntary pilgrimage by women in labor in search of childbirth care and to identify factors associated with this endeavor in two Brazilian cities. This was a cross-sectional study nested in the BRISA birth cohort, whose sample consisted of 10,475 women admitted to the selected maternity hospitals for delivery in São Luís (Maranhão State) and Ribeirão Preto (São Paulo State). Interviews were held with questionnaires that contained sociodemographic and obstetric variables. Hierarchical modeling was used, and relative risk was calculated with Poisson regression. Involuntary pilgrimage during labor was more frequent in São Luís (35.8%) than in Ribeirão Preto (5.8%). In São Luís, factors associated with pilgrimage were: first pregnancy (RR = 1.19; 95%CI: 1.08-1.31) and schooling less than 12 complete years. However, age 35 years or older (RR = 0.65; 95%CI: 0.54-0.84) was associated with less pilgrimage. In Ribeirão Preto, such trekking for obstetric care was more frequent in women with high-risk pregnancies (RR = 2.45; 95%CI: 1.81-3.32) and those with gestational age less than 37 weeks (RR = 1.93; 95%CI: 1.50-2.50). Meanwhile, delivery with gestational age equal to or greater than 42 weeks was associated with less pilgrimage (RR = 0.57; 95%CI: 0.33-0.98). In both cities, poor women had to trek more in search of childbirth care and had no guarantee of care, even for those who had received prenatal care. The study revealed the lack of guarantee of universal and equitable access and highlighted the unequal access to childbirth care between Brazil's major geographic regions.
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Barroso LN, Farias DR, Soares-Mota M, Bettiol H, Barbieri MA, Foss MC, Silva AAMD, Kac G. Waist circumference is an effect modifier of the association between bone mineral density and glucose metabolism. Arch Endocrinol Metab 2018; 62:285-295. [PMID: 29791653 PMCID: PMC10118778 DOI: 10.20945/2359-3997000000040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 12/20/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The role of bone markers on insulin resistance (IR) remains controversial. The objective of this study is to evaluate the association between bone mineral density (BMD) and glucose metabolism and investigate if visceral hyperadiposity, evaluated by waist circumference (WC), is an effect modifier of this association. SUBJECTS AND METHODS Cross-sectional analysis with 468 young adults from the fourth follow-up of the 1978/79 Ribeirão Preto prospective birth cohort, Brazil. BMD, total osteocalcin (OC), fasting plasma glucose and insulin concentrations were assessed. IR, sensitivity (S) and secretion (β) were estimated by homeostasis model assessment (HOMA) indexes. Multiple linear regression models were constructed to estimate the association between BMD and glucose metabolism. Beta coefficient, R2 and p-values were provided. WC was tested as an effect modifier and OC as a confounder. The covariates were selected based on Direct Acyclic Graph. RESULTS Significant interaction between BMD (femoral neck and proximal femur areas) and WC on glucose metabolism was observed in the adjusted models. Subjects with increased WC presented a positive association between BMD and log HOMA1-IR while an inverse association was found in those with normal WC (femoral neck R2 = 0.17, p = 0.036; proximal femur R2 = 0.16, p = 0.086). BMD was negatively associated with log HOMA2-S in individuals with increased WC and positively in those with normal WC (femoral neck R2 = 0.16, p = 0.042; proximal femur R2 = 0.15, p = 0.097). No significant associations between BMD, log HOMA2-β and OC and glucose metabolism markers were observed. CONCLUSIONS BMD was associated with glucose metabolism, independently of OC, and WC modifies this association.
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Affiliation(s)
- Lygia N Barroso
- Observatório de Epidemiologia Nutricional, Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro (UFRJ), Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, Brasil
| | - Dayana R Farias
- Observatório de Epidemiologia Nutricional, Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro (UFRJ), Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, Brasil
| | - Marcia Soares-Mota
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro (UFRJ), Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, Brasil
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Milton Cesar Foss
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Antônio Augusto M da Silva
- Departamento de Saúde Pública, Centro de Ciências da Saúde, Universidade Federal do Maranhão (UFMA), São Luís, MA, Brasil
| | - Gilberto Kac
- Observatório de Epidemiologia Nutricional, Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro (UFRJ), Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, Brasil
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Ferraro AA, Barbieri MA, da Silva AAM, Grandi C, Cardoso VC, Stein AD, Bettiol H. Contributions of relative linear growth and adiposity accretion from birth to adulthood to adult hypertension. Sci Rep 2017; 7:8928. [PMID: 28827571 PMCID: PMC5566373 DOI: 10.1038/s41598-017-09027-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/20/2017] [Indexed: 12/03/2022] Open
Abstract
While birth weight and weight gain have been associated with hypertension (HT), the association of linear growth, independently of weight gains, has been less well studied. We assessed the independent association of body mass index (BMI) and length at birth and changes in BMI and height during the first two decades of life with adult blood pressure (BP). A birth cohort (n = 1141) was assembled in 1978–79, and followed up at school-age and adulthood. We used conditional length and BMI measures. BMI at birth was inversely associated with HT; c-BMI from school age to adulthood and c-height from birth to school age were positively associated with hypertension. Early adiposity accretion from birth to 9 years and late linear growth from 9 to 24 years were not associated with increased HT. Regarding BP, systolic and diastolic BP presented similar partterns: the lower the BMI at birth the higher the adult BP; the higher the BMI gains in the first 2 decades of life the higher the adult BP; linear accretion only in the first decade of life was associated with adult BP. Linear growth in the first decade of life and fat accretion in the second decade are associated with adults HT.
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Affiliation(s)
| | - Marco Antônio Barbieri
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Carlos Grandi
- Department of Pediatrics, Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Heloisa Bettiol
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Bernardi JR, Goldani MZ, Pinheiro TV, Guimarães LSP, Bettiol H, da Silva AAM, Barbieri MA. Gender and social mobility modify the effect of birth weight on total and central obesity. Nutr J 2017. [PMID: 28651584 PMCID: PMC5485694 DOI: 10.1186/s12937-017-0260-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Little is known about the interaction between gender and low birth weight (LBW) and lifelong social mobility as an explanation of the etiology of obesity. The aim of the present study was to evaluate total and central obesity according to gender, LBW and social mobility, within the context of the epidemiological transition in middle-income countries. We hypothesize that there are more pronounced metabolic consequences of social mobility for women born with LBW. METHODS We used data from a birth cohort study conducted in Ribeirão Preto, São Paulo, Brazil. Data regarding anthropometric measurements, schooling and smoking status were collected at 23-25 years of age. Social mobility was determined based on maternal and adult offspring schooling and categorized as Low-Low, Low-High and High-High. Analysis of covariance was performed to assess the association between social mobility and body mass index (BMI) or waist circumference (WC) in adulthood, stratified by LBW and gender. RESULTS Data on 6827 singleton pregnancies were collected at birth in 1978/79 and a sample was followed up in 2002/04. A total of 2063 subjects were included in the study. Mean age was 23.9 ± 0.7 years, 51.8% (n = 1068) were female and the LBW was 6.2% (n = 128). There was a triple interaction between social mobility, LBW and gender. Among women born without LBW, BMI and WC were higher in the Low-Low group compared to High-High schooling group. Among LBW women, BMI and WC were higher in the Low-Low group compared to the Low-High group. CONCLUSIONS Women born with LBW belonging to the low schooling group in early adulthood had high BMI and WC, compared to the Low-High social mobility group.
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Affiliation(s)
- Juliana Rombaldi Bernardi
- Departamento de Nutrição, Universidade Federal do Rio Grande do Sul, Av. Jerônimo de Ornelas, 721 - Santana, 90040-341, Porto Alegre, Rio Grande do Sul, Brazil. .,Departamento de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Santana, 90035-003, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Marcelo Zubaran Goldani
- Departamento de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Santana, 90035-003, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tanara Vogel Pinheiro
- Departamento de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Santana, 90035-003, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciano Santos Pinto Guimarães
- Unidade de Bioestatística, Grupo de Pesquisa e Pós-graduação, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Santa Cecilia, 90035-903, Porto Alegre, Rio Grande do Sul, Brazil
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900 - Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Antônio Augusto Moura da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Av. dos Portugueses, 1966 - Vila Bacanga, MA, 65085-580, São Luís, Maranhão, Brazil
| | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900 - Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil
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Ribeiro MRC, da Silva AAM, Alves MTSSDBE, Batista RFL, Ribeiro CCC, Schraiber LB, Bettiol H, Barbieri MA. Effects of Socioeconomic Status and Social Support on Violence against Pregnant Women: A Structural Equation Modeling Analysis. PLoS One 2017; 12:e0170469. [PMID: 28107428 PMCID: PMC5249246 DOI: 10.1371/journal.pone.0170469] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 01/05/2017] [Indexed: 11/19/2022] Open
Abstract
Few studies have used structural equation modeling to analyze the effects of variables on violence against women. The present study analyzed the effects of socioeconomic status and social support on violence against pregnant women who used prenatal services. This was a cross-sectional study based on data from the Brazilian Ribeirão Preto and São Luís birth cohort studies (BRISA). The sample of the municipality of São Luís (Maranhão/Brazil) consisted of 1,446 pregnant women interviewed in 2010 and 2011. In the proposed model, socioeconomic status was the most distal predictor, followed by social support that determined general violence, psychological violence or physical/sexual violence, which were analyzed as latent variables. Violence was measured by the World Health Organization Violence against Women (WHO VAW) instrument. The São Luis model was estimated using structural equation modeling and validated with 1,378 pregnant women from Ribeirão Preto (São Paulo/Brazil). The proposed model showed good fit for general, psychological and physical/sexual violence for the São Luís sample. Socioeconomic status had no effect on general or psychological violence (p>0.05), but pregnant women with lower socioeconomic status reported more episodes of physical/sexual violence (standardized coefficient, SC = -0.136; p = 0.021). This effect of socioeconomic status was indirect and mediated by low social support (SC = -0.075; p<0.001). Low social support was associated with more episodes of general, psychological and physical/sexual violence (p<0.001). General and psychological violence indistinctly affected pregnant women of different socioeconomic status. Physical/sexual violence was more common for pregnant women with lower socioeconomic status and lower social support. Better social support contributed to reduction of all types of violence. Results were nearly the same for the validation sample of Ribeirão Preto except that SES was not associated with physical/sexual violence.
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Affiliation(s)
| | | | | | | | | | - Lilia Blima Schraiber
- Department of Preventive Medicine, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
| | - Heloisa Bettiol
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
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Larroudé MS, Aguilar G, Rossi I, Drelichman G, Fernandez Escobar N, Basack N, Slago M, Schenone A, Fynn A, Cuello MF, Fernandez R, Ruiz A, Reichel P, Guelbert N, Robledo H, Watman N, Bolesina M, Elena G, Veber SE, Pujal G, Galvan G, Chain JJ, Arizo A, Bietti J, Aznar M, Dragosky M, Marquez M, Feldman L, Muller K, Zirone S, Buchovsky G, Lanza V, Fernandez I, Jaureguiberry R, Barbieri MA, Maro A, Zarate G, Fernandez G, Rapetti M, Degano A, Kantor G, Albina A, Alvarez Bollea M, Arrocena H, Bacciedoni V, Del Rio F. Evaluation of Bone Mineral Density in Patients with Type 1 Gaucher Disease in Argentina. J Clin Densitom 2016; 19:444-449. [PMID: 27574779 DOI: 10.1016/j.jocd.2016.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 06/29/2016] [Accepted: 07/27/2016] [Indexed: 01/18/2023]
Abstract
The purpose of this study was to evaluate the frequency of osteoporosis (OP) in patients with Gaucher disease (GD) in Argentina. GD patients from 28 centers were consecutively included from April 2012 to 2014. Bone mineral density (BMD) was determined by dual X-ray absorptiometry in the lumbar spine and the femoral neck or the total proximal femur for patients ≥20 yr of age, and by whole-body scan in the lumbar spine in patients <20 yr of age. In children, mineral density was calculated using the chronological age and Z height. OP diagnosis was determined following adult and pediatric official position of the International Society for Clinical Densitometry. A total of 116 patients were included, of which 62 (53.5%) were women. The median age was 25.8 yr. All patients received enzyme replacement therapy, with a median time of 9.4 yr. Normal BMD was found in 89 patients (76.7%), whereas low bone mass (LBM) or osteopenia was found in 15 patients (13%) and OP in 12 patients (10.3%). The analysis of the pediatric population revealed that 4 patients (9.3%) had LBM and 3 (7%) had OP (Z-score ≤ -2 + fractures height-adjusted by Z), whereas in the adult population (n = 73), 11 patients (15%) had LBM or osteopenia and 9 (12.3%) had OP. Bone marrow infiltration and the presence of fractures were significantly correlated with the presence of OP (p = 0.04 and <0.001, respectively). This is the first study in Argentina and in the region describing the frequency of OP or LBM in GD patients treated with imiglucerase using the official position of the International Society for Clinical Densitometry.
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Affiliation(s)
- M S Larroudé
- Departamento de Densitometría ósea, Centro de Diagnóstico E. Rossi, Buenos Aires, Argentina; Departamento de Densitometría ósea, Hospital Cesar Milstein, Buenos Aires, Argentina.
| | - G Aguilar
- Departamento de Densitometría ósea, Centro de Diagnóstico E. Rossi, Buenos Aires, Argentina
| | - I Rossi
- Departamento de Densitometría ósea, Centro de Diagnóstico E. Rossi, Buenos Aires, Argentina
| | - G Drelichman
- Hospital de Niños "Ricardo Gutiérrez," CABA, Buenos Aires, Argentina
| | | | - N Basack
- Hospital de Niños "Ricardo Gutiérrez," CABA, Buenos Aires, Argentina
| | - M Slago
- Department of Hematology, Laboratorio de Neuroquímica "Dr. N.A. Chamoles," Buenos Aires, Argentina
| | - A Schenone
- Department of Hematology, Laboratorio de Neuroquímica "Dr. N.A. Chamoles," Buenos Aires, Argentina
| | - A Fynn
- Department of Hematology, Hospital de Niños "Sor María Ludovica," La Plata, Argentina
| | - M F Cuello
- Department of Hematology, Hospital de Niños "Sor María Ludovica," La Plata, Argentina
| | - R Fernandez
- Department of Hematology, Hospital de Niños "Sor María Ludovica," La Plata, Argentina
| | - A Ruiz
- Department of Hematology, Hospital CEpsi Eva Perón, Santiago del Estero, Argentina
| | - P Reichel
- Department of Hematology, Hospital CEpsi Eva Perón, Santiago del Estero, Argentina
| | - N Guelbert
- Department of Hematology, Hospital Provincial de Niños "Santa Trinidad," Córdoba, Argentina
| | - H Robledo
- Department of Hematology, Hospital Provincial de Niños "Santa Trinidad," Córdoba, Argentina
| | - N Watman
- Hospital Ramos Mejía, CABA, Buenos Aires, Argentina
| | - M Bolesina
- Hospital Ramos Mejía, CABA, Buenos Aires, Argentina
| | - G Elena
- Hospital de Niños Pedro de Elizalde, CABA, Buenos Aires, Argentina
| | - S E Veber
- Hospital de Niños Pedro de Elizalde, CABA, Buenos Aires, Argentina
| | - G Pujal
- Department of Hematology, Hospital "Dr. Julio C. Perrando," Chaco, Argentina
| | - G Galvan
- Department of Hematology, Hospital "Dr. Julio C. Perrando," Chaco, Argentina
| | - J J Chain
- Department of Hematology, Hospital del Niño Jesús, Tucumán, Argentina
| | - A Arizo
- Department of Hematology, Hospital Iturraspe, Santa Fe, Argentina
| | - J Bietti
- Department of Hematology, Hospital Iturraspe, Santa Fe, Argentina
| | - M Aznar
- Department of Hematology, Instituto Médico Platense, La Plata, Argentina
| | - M Dragosky
- Department of Hematology, Hospital de Oncología "M. Curie," Buenos Aires, Argentina
| | - M Marquez
- Department of Hematology, Hospital de Oncología "M. Curie," Buenos Aires, Argentina
| | - L Feldman
- Clínica Modelo de Tandil, Pcia, Buenos Aires, Argentina
| | - K Muller
- Clínica Modelo de Tandil, Pcia, Buenos Aires, Argentina
| | - S Zirone
- Department of Hematology, Clínica del Niño del Rosario, Santa Fe, Argentina
| | - G Buchovsky
- Department of Hematology, Hospital Escuela de Corrientes, Corrientes, Argentina
| | - V Lanza
- Hospital Materno Infantil de Mar del Plata, Pcia, Buenos Aires, Argentina
| | - I Fernandez
- Hospital de Del Viso, Pcia, Buenos Aires, Argentina
| | - R Jaureguiberry
- Department of Hematology, Hospital de San Martín, La Plata, Argentina
| | | | - A Maro
- Hospital Alemán, CABA, Buenos Aires, Argentina
| | - G Zarate
- Hospital Pirovano, CABA, Buenos Aires, Argentina
| | - G Fernandez
- Hospital Pirovano, CABA, Buenos Aires, Argentina
| | - M Rapetti
- Hospital de Niños de San Justo, Pcia, Buenos Aires, Argentina
| | - A Degano
- Sanatorio General Sarmiento, Pcia, Buenos Aires, Argentina
| | - G Kantor
- Hospital Durand, CABA, Buenos Aires, Argentina
| | - A Albina
- Consultorio Particular, Mar Del Plata, Prov, Buenos Aires, Argentina
| | - M Alvarez Bollea
- Department of Hematology, Sanatorio Allende de Córdoba, Córdoba, Argentina
| | - H Arrocena
- Hospital Centenario, Gualeguychu, Entre Ríos, Argentina
| | - V Bacciedoni
- Department of Hematology, Hospital Lagomaggiore, Mendoza, Argentina
| | - F Del Rio
- Department of Hematology, Hospital Lagomaggiore, Mendoza, Argentina
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Pereira TBDB, Thomaz EBAF, do Nascimento FRF, dos Santos APSDA, Batista RLF, Bettiol H, Cavalli RDC, Barbieri MA, da Silva AAM. Regulatory Cytokine Expression and Preterm Birth: Case-Control Study Nested in a Cohort. PLoS One 2016; 11:e0158380. [PMID: 27486805 PMCID: PMC4972408 DOI: 10.1371/journal.pone.0158380] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 05/10/2016] [Indexed: 11/20/2022] Open
Abstract
Background Currently known risk factors explain only a small fraction of preterm birth (PTB). Previous PTB is one of the most important predictors. However, this information is not available in primiparous women. Few studies have looked at associations between regulatory cytokine expression (RCE) and PTB and the results are conflicting. Objective To investigate the association of RCE–Interleukin 10 (IL-10) and Transforming Growth Factor β (TGF-β)–with PTB, and to assess whether bacterial vaginosis (BV) is involved in this relationship. Methods This was a case-control study nested in a prospective cohort–called BRISA. Women with singleton pregnancies were interviewed from 22 to 25 weeks of gestational age (GA). Women were recruited from health services in São Luís, Brazil. A blood sample was collected and gynecological examination was performed. Serum IL-10 and TGF-β were determined using cytometric bead array. Nugent score >7 and/or the presence of clue cells were used for BV diagnosis. All PTB estimated by ultrasound dating performed before 20 weeks of gestational age were considered cases. Controls were selected by simple random sampling from the rest of the cohort, at a 2:1 ratio. Different models were tested, according to the main independent variable. Odds ratios (OR) and 95% confidence intervals (95%CI) were estimated by regression analyses. Results The study included 327 pregnant women, 109 cases and 218 controls. No associations were found between BV and PTB (P = 1.44; 95%CI: 0.51–3.77). Low levels of IL-10 (OR = 2.92 95%CI: 1.38–6.16) or TGF-β (OR = 16.90 95%CI: 6.42–44.51) or both simultaneously (OR = 77.16 95%CI: 7.99–744.88) were associated with increasing odds of PTB, even after adjustment for confounding. Conclusion Decreased RCE is a risk factor for PTB. This relationship, however, is not triggered by the presence of BV. Low IL-10/TGF-β levels from 22 to 25 weeks of GA could be used as early predictors of PTB. We suggest monitoring of these RCE, especially among primiparous women, for whom history of previous PTB is not available.
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Affiliation(s)
| | | | | | | | | | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | | | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Augusto Moura da Silva
- Department of Public Health, Graduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Goudard MJF, Simões VMF, Batista RFL, Queiroz RCDS, Alves MTSSDBE, Coimbra LC, Martins MDG, Barbieri MA, Nathasje IF. Inadequação do conteúdo da assistência pré-natal e fatores associados em uma coorte no nordeste brasileiro. Ciênc saúde coletiva 2016; 21:1227-38. [DOI: 10.1590/1413-81232015214.12512015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 08/01/2015] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo desta pesquisa foi analisar o conteúdo da assistência pré-natal em São Luís e os fatores associados com sua inadequação. Realizou-se estudo transversal baseado em dados da coorte de nascimento de São Luís em 2010. O conteúdo da assistência pré-natal foi classificado como inadequado quando não atendeu aos critérios do Programa de Humanização no Pré-Natal e Nascimento (PHPN) que estabelece o início precoce, o número mínimo de consultas, os exames laboratoriais básicos, a vacinação antitetânica e os procedimentos obstétricos. Regressão de Poisson foi utilizada para observar associações das variáveis com o desfecho. A taxa de inadequação foi de 60,2%. O pré-natal inadequado foi associado à classe econômica C (RP = 1,39; IC = 1,26-1,55), à D/E (RP = 1,60; IC = 1,43-1,79), à ocupação da mãe não qualificada/desempregada (RP = 1,24; IC = 1,11-1,37), à escolaridade de 5-8 anos (RP = 1,12; IC = 1,06-1,19) e de 0-4 anos (RP = 1,13; IC = 1,01-1,26), a não ter religião (RP = 1,10; IC = 1,04-1,17), ao uso de álcool durante a gestação (RP = 1,13; IC = 1,06-1,20) e ao atendimento no serviço público (RP = 1,75; IC = 1,54-2,00). Os resultados demonstraram inadequação e iniquidade da assistência pré-natal, evidenciando que mulheres de pior condição socioeconômica foram as que receberam assistência de menor qualidade.
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Mustafi S, Barbieri MA. Rin1 restores host phagocytic activity during invasion by Pseudomonas aeruginosa. J Med Microbiol 2016; 65:351-361. [PMID: 26902911 DOI: 10.1099/jmm.0.000235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pseudomonas aeruginosa uses a type III secretion system to deliver toxic effector proteins directly into host cells and alter host protein functions. Exoenzyme S (ExoS), a type III effector protein, ADP-ribosylates Rab5 GTPase and impairs early phagocytic events in macrophage cells. In this study, we tested the hypothesis that Rin1, a Ras effector protein and Rab5 guanine nucleotide exchange factor, generates an intrinsic Rab5 activity cycle during phagocytosis of live P. aeruginosa; thus, allowing proper phagocytic killing. We found that Rab5 activity was attenuated at a very early time point (2.5 min) of the phagocytic process of live but not of heat-inactivated P. aeruginosa. However, upon overexpressing Rin1 in macrophages, the Rab5 activity sustained for a prolonged time (∼20 min) counteracting the negative effects during phagocytosis of live P. aeruginosa. Ras, also a substrate of the ADP-ribosyltransferase activity of ExoS, remained active during the early events of phagocytosis of live as well as heat-inactivated P. aeruginosa. Further examinations revealed that the Rin1 : Vps9 domain (the Rab5 nucleotide catalytic domain) and the Rin1 : RA domain (the Ras association domain of Rin1) are both required for optimal Rin1 function. Finally, the time-based analysis of the ADP-ribosylation status of Rab5 and Ras obtained from this study was consistent in the context of the regulation of (i) Rab5 activity by Rin1 : Vps9 domain and (ii) Ras interaction with Rin1 via the Rin1 : RA domain. These observations highlight a novel crosstalk between Rin1-Rab5 and Rin1-Ras complexes that offsets the anti-phagocytic effects of ExoS in macrophages.
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Affiliation(s)
- S Mustafi
- Department of Biological Sciences, Florida International University, Miami, FL 33199, USA
| | - M A Barbieri
- Fairchild Tropical Botanic Garden, 10901 Old Cutler Road, Coral Gables, FL 33156, USA.,Biomolecular Sciences Institute, Florida International University, Miami, FL 33199, USA.,Department of Biological Sciences, Florida International University, Miami, FL 33199, USA.,International Center of Tropical Botany, Florida International University, Miami, FL 33199, USA
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Porther N, Barbieri MA. The role of endocytic Rab GTPases in regulation of growth factor signaling and the migration and invasion of tumor cells. Small GTPases 2015; 6:135-44. [PMID: 26317377 PMCID: PMC4601184 DOI: 10.1080/21541248.2015.1050152] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 05/04/2015] [Accepted: 05/07/2015] [Indexed: 01/05/2023] Open
Abstract
Metastasis is characterized pathologically by uncontrolled cell invasion, proliferation, migration and angiogenesis. It is a multistep process that encompasses the modulation of membrane permeability and invasion, cell spreading, cell migration and proliferation of the extracellular matrix, increase in cell adhesion molecules and interaction, decrease in cell attachment and induced survival signals and propagation of nutrient supplies (blood vessels). In cancer, a solid tumor cannot expand and spread without a series of synchronized events. Changes in cell adhesion receptor molecules (e.g., integrins, cadherin-catenins) and protease expressions have been linked to tumor invasion and metastasis. It has also been determined that ligand-growth factor receptor interactions have been associated with cancer development and metastasis via the endocytic pathway. Specifically, growth factors, which include IGF-1 and IGF-2 therapy, have been associated with most if not all of the features of metastasis. In this review, we will revisit some of the key findings on perhaps one of the most important hallmarks of cancer metastasis: cell migration and cell invasion and the role of the endocytic pathway in mediating this phenomenon.
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Affiliation(s)
- N Porther
- Department of Biological Sciences; Florida International University; Miami, FL USA
| | - MA Barbieri
- Department of Biological Sciences; Florida International University; Miami, FL USA
- Biomolecular Sciences Institute; Florida International University; Miami, FL USA
- Fairchild Tropical Botanic Garden; Coral Gables, FL USA
- International Center of Tropical Botany; Florida International University; Miami, FL USA
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Bernardi JR, Pinheiro TV, Mueller NT, Goldani HAS, Gutierrez MRP, Bettiol H, Moura da Silva AA, Barbieri MA, Goldani MZ. Cesarean delivery and metabolic risk factors in young adults: a Brazilian birth cohort study. Am J Clin Nutr 2015; 102:295-301. [PMID: 26085513 PMCID: PMC6546227 DOI: 10.3945/ajcn.114.105205] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 05/13/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cesarean delivery (CD) perturbs the assembly of the neonatal gut microbiome and has been associated with child and adult obesity. However, it is still unknown whether CD is associated with metabolic risk factors in young adults. OBJECTIVE We investigated the association of CD and metabolic risk factors in young adults in a cohort study who were 23-25 y of age at follow-up. DESIGN We used data from a cohort study in Ribeirão Preto, Brazil. Baseline data on 6827 singleton pregnancies were collected in 1978-1979, and a sample of 2063 subjects were followed up 23-25 y later (2002-2004). Information on the type of delivery, birth weight, maternal age, parity, maternal schooling, and maternal smoking was obtained after birth. Anthropometric data, biochemical measurements, and information on participant schooling and smoking history were collected at 23-25 y of age. A linear regression was performed to assess the association between CD and biochemical measurements in early adulthood, controlling for a minimum set of confounders that were identified in a directed acyclic graph. RESULTS The mean ± SD age of the subjects was 23.9 ± 0.71 y, and 51.8% of the sample were women. The CD rate was 32.0% and was more common in older (P < 0.001) and more educated mothers (P < 0.001). Compared with vaginal delivery, CD was associated with higher body mass index (BMI) after multivariable adjustment (P < 0.001) but not with glucose, homeostasis model assessment of insulin resistance, the quantitative insulin-sensitivity check index, total cholesterol, LDL cholesterol, HDL cholesterol, or triglycerides (all P > 0.05). CONCLUSION In our sample of Brazilian adults, CD was associated with higher BMI but not with other metabolic risk factors.
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Affiliation(s)
- Juliana Rombaldi Bernardi
- Biological and Health Sciences Center, University of Caxias do Sul, Caxias do Sul, Brazil; Department of Pediatrics, Porto Alegre Clinical Hospital, Faculty of Medicine, University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Tanara Vogel Pinheiro
- Department of Pediatrics, Porto Alegre Clinical Hospital, Faculty of Medicine, University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Helena Ayako Sueno Goldani
- Department of Pediatrics, Porto Alegre Clinical Hospital, Faculty of Medicine, University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Heloisa Bettiol
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, Brazil; and
| | | | - Marco Antônio Barbieri
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, Brazil; and
| | - Marcelo Zubaran Goldani
- Department of Pediatrics, Porto Alegre Clinical Hospital, Faculty of Medicine, University of Rio Grande do Sul, Porto Alegre, Brazil;
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Figueiredo FPD, Parada AP, Cardoso VC, Batista RFL, Silva AAMD, Barbieri MA, Cavalli RDC, Bettiol H, Del-Ben CM. Postpartum depression screening by telephone: a good alternative for public health and research. Arch Womens Ment Health 2015; 18:547-53. [PMID: 25380783 DOI: 10.1007/s00737-014-0480-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 10/18/2014] [Indexed: 11/24/2022]
Abstract
This study verified the reliability and validity of the Edinburg Postpartum Depression Scale (EPDS) administered by telephone interviews. In a cross-sectional study of a cohort from Brazil (BRISA), the EPDS was administered by telephone to 1,083 women within 12 months postpartum, and 257 (23.7 %) participants had an EPDS score ≥10. At 67 ± 48 days after their telephone interview, 199 (EPDS ≥10 = 96; EPDS <10 = 103) participants were interviewed face-to-face using the Structured Clinical Interview for DSM-IV (SCID) and completed the EPDS again by self-report. In 90 participants, the diagnosis of major depressive episode was confirmed by the SCID (EPDS ≥10 = 65; EPDS <10 = 25). The Cronbach's alpha coefficient was 0.861. The Spearman's correlation between the EPDS administered by telephone and the self-reported EPDS was 0.69 (p < 0.001). The receiver-operating characteristic (ROC) curve for the EPDS administered by telephone was 0.78 (95 % confidence interval (CI) = 0.72 to 0.84). Scores ≥10 showed a sensitivity of 72.2 %, a specificity of 71.6 %, and a positive predictive value of 67.7 %. The application of the EPDS by telephone is a suitable alternative for clinical practice and research and represents a method to optimize the diagnosis of postpartum depression.
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Affiliation(s)
- Felipe Pinheiro de Figueiredo
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, Av. dos Bandeirantes 3900, Ribeirao Preto, SP, 14048-900, Brazil,
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Lamy Filho F, de Sousa SHC, Freitas IJS, Lamy ZC, Simões VMF, da Silva AAM, Barbieri MA. Effect of maternal skin-to-skin contact on decolonization of Methicillin-Oxacillin-Resistant Staphylococcus in neonatal intensive care units: a randomized controlled trial. BMC Pregnancy Childbirth 2015; 15:63. [PMID: 25880822 PMCID: PMC4374510 DOI: 10.1186/s12884-015-0496-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 03/05/2015] [Indexed: 11/17/2022] Open
Abstract
Background Decolonization with topical antibiotics is necessary to control outbreaks of multidrug-resistant bacterial infection in the Neonatal Intensive Care Unit (NICU), but can trigger bacterial resistance. The objective of this study was to determine whether skin-to-skin contact of newborns colonized with Methicillin-Oxacillin Resistant Staphylococcus aureus or Methicillin-Oxacillin-Resistant Coagulase-Negative Staphylococcus aureus (MRSA/MRSE) with their mothers could be an effective alternative to promote bacterial decolonization of newborns’ nostrils. Methods We performed a randomized clinical trial with 102 newborns admitted to the NICU in three hospitals in São Luís, Brazil. Inclusion criteria were birth weight of 1300 to 1800 g, more than 4 days of hospitalization, newborns with positive nostril cultures for MRSA and/or multidrug-resistant coagulase-negative Staphylococcus and mothers not colonized by these bacteria. We used a random number algorithm for randomization. Allocation was performed using sealed opaque envelopes. Skin-to-skin contact was given twice a day for 60 minutes for seven consecutive days. The control group received routine care without skin-to-skin contact. There was no masking of newborn’s mothers or researchers but the individuals who carried out bacterial cultures and assessed results were kept blind to group allocation. The primary outcome was colonization status of newborns’ nostrils after 7 days of intervention. The directional hypothesis was that more newborns who receive skin-to-skin holding 2 hours/day for 7 days than newborns who receive normal care will be decolonized. Results Decolonization of MRSA/MRSE was greater in the intervention group (Risk Ratio = 2.27; 95% CI 1.27-4.07, p-value = 0.003). Number Needed to Treat (NNT) was 4.0 (95% CI 2.2 – 9.4). After adjustment for the possible confounding effects of small for gestational age birth, antibiotic use, need for resuscitation, sex and cesarean delivery, skin-to-skin contact remained strongly associated with decolonization of newborns’ nostrils from MRSA/MRSE bacteria (p = 0.007). There was no need to interrupt the trial for safety reasons. Conclusion Skin-to-skin contact might be an effective and safe method for promoting decolonization of newborns’ nostrils colonized by MRSA/MRSE. Trial Registration The study was registered with ClinicalTrials.gov (NCT01498133, November 21, 2011).
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Affiliation(s)
- Fernando Lamy Filho
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão, Brazil.
| | | | - Isolina Januária Sousa Freitas
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão, Brazil.
| | - Zeni Carvalho Lamy
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão, Brazil.
| | - Vanda Maria Ferreira Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão, Brazil.
| | - Antônio Augusto Moura da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão, Brazil.
| | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria (7° andar HCRP), Faculdade de Medicina de Ribeirão Preto - USP, Universidade de São Paulo, Av. Bandeirantes, 3900 - Campus USP, Ribeirão Preto, Brazil.
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Ribeiro MRC, Alves MTSSDBE, Batista RFL, Ribeiro CCC, Schraiber LB, Barbieri MA, Bettiol H, da Silva AAM. Confirmatory factor analysis of the WHO Violence Against Women instrument in pregnant women: results from the BRISA prenatal cohort. PLoS One 2014; 9:e115382. [PMID: 25531654 PMCID: PMC4274028 DOI: 10.1371/journal.pone.0115382] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/21/2014] [Indexed: 11/19/2022] Open
Abstract
Background Screening for violence during pregnancy is one of the strategies for the prevention of abuse against women. Since violence is difficult to measure, it is necessary to validate questionnaires that can provide a good measure of the phenomenon. The present study analyzed the psychometric properties of the World Health Organization Violence Against Women (WHO VAW) instrument for the measurement of violence against pregnant women. Methods Data from the Brazilian Ribeirão Preto and São Luís birth cohort studies (BRISA) were used. The sample consisted of 1,446 pregnant women from São Luís and 1,378 from Ribeirão Preto, interviewed in 2010 and 2011. Thirteen variables were selected from a self-applied questionnaire. Confirmatory factor analysis was used to investigate whether violence is a uni-or-multidimensional construct consisting of psychological, physical and sexual dimensions. The mean-and-variance-adjusted weighted least squares estimator was used. Models were fitted separately for each city and a third model combining data from the two settings was also tested. Models suggested from modification indices were tested to determine whether changes in the WHO VAW model would produce a better fit. Results The unidimensional model did not show good fit (Root mean square error of approximation [RMSEA] = 0.060, p<0.001 for the combined model). The multidimensional WHO VAW model showed good fit (RMSEA = 0.036, p = 0.999 for the combined model) and standardized factor loadings higher than 0.70, except for the sexual dimension for SL (0.65). The models suggested by the modification indices with cross loadings measuring simultaneously physical and psychological violence showed a significantly better fit compared to the original WHO model (p<0.001 for the difference between the model chi-squares). Conclusions Violence is a multidimensional second-order construct consisting of psychological, physical and sexual dimensions. The WHO VAW model and the modified models are suitable for measuring violence against pregnant women.
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Affiliation(s)
| | | | | | | | - Lilia Blima Schraiber
- Department of Preventive Medicine, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Heloisa Bettiol
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
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Silveira MF, Matijasevich A, Horta BL, Bettiol H, Barbieri MA, Silva AA, Rondó PHC, Lunardelli AN, Peres MA, Gurgel RQ, Cunha AL, Calvano LM, Amin J, Leal MDC, Matos ACG, Maranhão AG, Cortez-Escalante JJ, Barros AJD, Barros FC, Victora CG. [Prevalence of preterm birth according to birth weight group: a systematic review]. Rev Saude Publica 2014; 47:992-1003. [PMID: 24626505 DOI: 10.1590/s0034-8910.2013047004997] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 09/23/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of preterm birth by categories of birth weight, and to obtain an equation to correct the estimates. METHODS Systematic review of the Brazilian literature published from 1990 to 2012, to identify studies with primary collection of data on birth weight and gestational age. Twelve studies were selected and contributed for tabulations of preterm prevalence according to 100 g birth weight categories. These results were combined using sex-specific fractional polynomial equations and the resulting curves were compared with results from the Live Birth Information System for the years 2000, 2005, 2010 and 2011. RESULTS For all birth weight categories, preterm prevalence estimates based on primary studies had a higher prevalence than those of the the Live Birth Information System. The prevalence reported by the Live Birth Information System was of 7.2% in 2010, about 38.0% lower than the estimated prevalence of 11.7% obtained with the correctional equation. CONCLUSIONS Information reported by the Live Birth Information System on preterm prevalence does not reflect the true magnitude of the problem in Brazil, and should not be used without the correction factors proposed in the present analyses.
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Bernardes ACF, da Silva RA, Coimbra LC, Alves MTSSDB, Queiroz RCDS, Batista RFL, Bettiol H, Barbieri MA, da Silva AAM. Inadequate prenatal care utilization and associated factors in São Luís, Brazil. BMC Pregnancy Childbirth 2014; 14:266. [PMID: 25108701 PMCID: PMC4133632 DOI: 10.1186/1471-2393-14-266] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 08/05/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Over the last decades there has been a reduction of social inequalities in Brazil, as well as a strong expansion of health services, including prenatal care. The objective of the present study was to estimate the rate of inadequate prenatal care utilization and its associated factors in São Luís, Brazil, in 2010 and to determine whether there was a reduction of inequity in prenatal care use by comparing the present data to those obtained from a previous cohort started in 1997/98. METHODS Data from the BRISA (Brazilian birth cohort studies of Ribeirão Preto and São Luís) population-based cohort, which started in 2010 (5067 women), were used. The outcome variable was the inadequate utilization of prenatal care, classified according to the recommendations of the Brazilian Ministry of Health. The explanatory variables were organized into three hierarchical levels based on the Andersen's behavioral model of the use of health services: predisposing, enabling and need factors. RESULTS Only 2.0% of the women did not attend at least one prenatal care visit. The rate of inadequate prenatal care utilization was 36.7%. Despite an improved adequacy of prenatal care use from 47.3% in 1997/98 to 58.2% in 2010, social inequality persisted: both low maternal schooling (prevalence ratio (PR) = 2.78; 95% confidence interval (95% CI) 2.23-3.47 for 0 to 4 years of study) and low family income, less than 0.5 monthly minimum wage per capita (PR = 1.37; 95% CI 1.22-1. 54), continued to be associated with higher rates of inadequate prenatal care utilization. Racial disparity regarding adequate utilization of prenatal services was detected, with black (PR = 1.19; 95% CI 1.04-1.36) and mulatto (PR = 1.14; 95% CI 1.02-1.26) women showing higher rates of inadequate use. On the other hand, women covered by the FHP - Family Health Program (PR = 0.92; 95% CI 0.85-0.98) showed a lower rate of inadequate prenatal care utilization. CONCLUSIONS Despite strong expansion of health services and expressive improvements in adequate prenatal care use and social indicators, inequalities in prenatal care use still persist. The FHP seems to be effective in reducing inadequate prenatal care utilization.
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Affiliation(s)
- Ariane Cristina Ferreira Bernardes
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
| | - Raimundo Antonio da Silva
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
| | - Liberata Campos Coimbra
- />Department of Nursing, Federal University of Maranhão, Brazil, Rua Viana Vaz, 230, Centro, São Luís, Maranhão 65020-660 Brazil
| | | | - Rejane Christine de Sousa Queiroz
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
| | - Rosângela Fernandes Lucena Batista
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
| | - Heloisa Bettiol
- />Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil, Avenida Bandeirantes, 3900, Hospital das Clínicas de Ribeirão Preto, Monte Alegre, Ribeirão Preto, São Paulo 14049-900 Brazil
| | - Marco Antônio Barbieri
- />Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil, Avenida Bandeirantes, 3900, Hospital das Clínicas de Ribeirão Preto, Monte Alegre, Ribeirão Preto, São Paulo 14049-900 Brazil
| | - Antônio Augusto Moura da Silva
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
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Arruda SPM, da Silva AAM, Kac G, Goldani MZ, Bettiol H, Barbieri MA. Socioeconomic and demographic factors are associated with dietary patterns in a cohort of young Brazilian adults. BMC Public Health 2014; 14:654. [PMID: 24969831 PMCID: PMC4082487 DOI: 10.1186/1471-2458-14-654] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 05/27/2014] [Indexed: 11/23/2022] Open
Abstract
Background The aim of the present study was to identify the main dietary patterns among young adults and to investigate the association of socioeconomic and demographic factors, and social mobility with dietary patterns. Methods Data from the fourth follow-up of the 1978/79 Ribeirão Preto birth cohort study, Brazil, were used. A total of 2,061 young adults, whose mothers gave sociodemographic information at birth in 1978–79, provided sociodemographic and dietary data through a validated food frequency questionnaire in 2002–2004, when they were aged 23–25 years. Those whose caloric intake was outside of the ±3 standard deviation range were excluded, leaving 2,034 individuals. The dietary patterns were identified by principal component analysis followed by varimax orthogonal rotation. Poisson regression with robust estimation of variance was used to derive prevalence ratios (PR). Results Four dietary patterns were identified: healthy, traditional Brazilian, energy-dense and bar. In the adjusted analysis, individuals with higher schooling (≥12 years) in adult life (PR = 1.51, 95% CI: 1.07-2.14) showed greater adherence whilst men (PR = 0.79, 95% CI: 0.68-0.93) had lower adherence to the healthy pattern. The highest adherence to the traditional Brazilian pattern was found for men (PR = 2.39, 95% CI: 2.04-2.80), mullatos (PR = 1.41, 95% CI: 1.21-1.64), households with ≥2 members, and for those with children (PR = 1.28, 95% CI: 1.07-1.55) while individuals with higher schooling in adulthood (≥12 years) (PR = 0.47, 95% CI: 0.34-0.65), higher family income in adulthood (≥20 MW) (PR = 0.57, 95% CI: 0.33-0.99) and higher family income at birth (≥6.1 MW) showed lower adherence. The bar pattern was positively associated with male sex (PR = 2.96, 95% CI: 2.47-3.55) and low schooling (≤8 years). The energy-dense pattern was not associated with any of the variables investigated. Social mobility was associated with the traditional Brazilian pattern. Men and women who were not poor at birth and remained so in adulthood showed lower adherence to this pattern (PR = 0.70, 95% CI: 0.53-0.94 for men and PR = 0.40, 95% CI: 0.20-0.80 for women). Conclusions Four different dietary patterns were identified among young adults. Socioeconomic and demographic factors, and social mobility were associated with food choices.
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Affiliation(s)
| | | | | | | | | | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Faculty of Medicine de Ribeirão Preto, University of São Paulo, Av, Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo 14,049-900, Brazil.
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Veloso HJF, da Silva AAM, Bettiol H, Goldani MZ, Filho FL, Simões VMF, Batista RFL, Barbieri MA. Low birth weight in São Luís, northeastern Brazil: trends and associated factors. BMC Pregnancy Childbirth 2014; 14:155. [PMID: 24885887 PMCID: PMC4108005 DOI: 10.1186/1471-2393-14-155] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 04/24/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To analyze trends in LBW (low birth weight) rate using birth registry data and identify factors associated with LBW in São Luís comparing two birth cohorts separated by a 12-year interval. METHODS 2,426 births were included in 1997/98 and 5,040 in 2010. The dependent variable was LBW (<2,500 g). Multiple logistic regression was performed to determine the association of independent variables with LBW. Data were also obtained from SINASC (Brazilian National Birth Registry) to analyze stillbirth and LBW rates trends from 1996 to 2010, using 3-year moving averages. RESULTS LBW, intrauterine growth restriction (IUGR) and preterm birth rates did not differ between the two cohorts. Despite this, birth registry data showed increasing LBW rate up to 2001, coinciding with decreasing stillbirth rate. Both stillbirth and LBW rates decreased thereafter. A significant reduction was observed in the percentage of teenage mothers, mothers with up to 4 years of education, family income up to one minimum wage and mothers who did not attend prenatal care. There was an increase in maternal age ≥35 years and schooling ≥12 years. The variables associated with LBW in 1997/98 were young maternal age (<18 years), maternal smoking during pregnancy and primiparity. Variables that remained in the adjusted model in 2010 were female gender, income <3 minimum wages, lack of prenatal care, maternal smoking during pregnancy and primiparity. CONCLUSIONS Although LBW rate did not differ between the two cohorts, this apparent stability masked an increase up to 2001 and a decrease thereafter. The rise in LBW rate paralleled reduction in the stillbirth rate, suggesting improvement in obstetrical and newborn care. Maternal, socioeconomic and demographic factors associated with LBW differed between the two cohorts, except for smoking during pregnancy and parity that were significantly associated with LBW in both cohorts.
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Affiliation(s)
- Helma Jane Ferreira Veloso
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary 155 Centro, São Luís, MA 65020-070, Brazil
| | - Antônio Augusto Moura da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary 155 Centro, São Luís, MA 65020-070, Brazil
| | - Heloísa Bettiol
- Departamento de Puericultura e Pediatria. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Hospital das Clínicas de Ribeirão Preto, 7°. andar. Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Marcelo Zubarán Goldani
- Departamento de Pediatria e Puericultura. Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil
| | - Fernando Lamy Filho
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary 155 Centro, São Luís, MA 65020-070, Brazil
| | - Vanda Maria Ferreira Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary 155 Centro, São Luís, MA 65020-070, Brazil
| | | | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Hospital das Clínicas de Ribeirão Preto, 7°. andar. Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
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Ribeiro MRC, da Silva AAM, e Alves MTSSDB, Batista RFL, de Rocha LMLN, Schraiber LB, Medeiros NL, Costa DCS, Bettiol H, Barbieri MA. Psychological violence against pregnant women in a prenatal care cohort: rates and associated factors in São Luís, Brazil. BMC Pregnancy Childbirth 2014; 14:66. [PMID: 24521235 PMCID: PMC3927820 DOI: 10.1186/1471-2393-14-66] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 02/04/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Violence against pregnant women has been associated with gestational and perinatal disorders. Psychological violence is the type least investigated and its associated factors have been little studied. The present study was conducted in order to estimate prevalence rates and analyze the factors associated with exclusive and recurrent psychological violence in the municipality of São Luís, Brazil. METHODS Data regarding 982 pregnant women, aged from 14 to 45 years, interviewed in 2010 and 2011 in a prenatal cohort were used. A self-applied questionnaire was used to screen for violence. Pregnant women submitted to physical and sexual violence were excluded from the analysis of factors associated with exclusive psychological violence. Prevalence ratios and 95% confidence intervals were estimated by a Poisson regression model with a hierarchical approach at three levels. At level 1 of the theoretical-conceptual model, we analyzed demographic and socioeconomic characteristics and variables that express gender inequalities; at level 2, we analyzed social support received by the women, and at level 3, the life experiences of the pregnant women. RESULTS Prevalence rate of exclusive psychological violence was 41.6% and of recurrent violence was 32.6%. Exclusive psychological violence was associated with pregnant women's age of 14 to 18 years (PR: 1.32 95% CI: 1.04 - 1.70), pregnant women's schooling superior to that of her intimate partner (PR: 1.54 95% CI: 1.09 - 2.16), inadequate social affective support/positive social interaction (PR: 1.34 95% CI: 1.11 - 1.62), use of illicit drugs by the pregnant women (PR: 1.80 95% CI: 1.16 - 2.81) and having had six or more intimate partners in life (PR: 1.52 95% CI: 1.18 - 1.96). Recurrent exclusive psychological violence was associated with inadequate social affective support/positive social interaction (PR: 1.47 95% CI: 1.15 - 1.87), use of illicit drugs by the pregnant women (PR: 2,28 95% CI: 1,40 - 3,71) and having had six or more intimate partners in life (PR: 1.47 95% CI: 1.06 - 2.03). CONCLUSIONS Psychological violence was a common phenomenon in this population of pregnant women that was associated with gender inequalities, inadequate social support and illicit drug use and should be routinely investigated during prenatal visits at health care services.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Heloisa Bettiol
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Guimarães AMDN, Bettiol H, Souza LD, Gurgel RQ, Almeida MLD, Ribeiro ERDO, Goldaniv MZ, Barbieri MA. Is adolescent pregnancy a risk factor for low birth weight? Rev Saude Publica 2014; 47:11-9. [PMID: 23703125 DOI: 10.1590/s0034-89102013000100003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 07/26/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate whether adolescent pregnancy is a risk factor for low birth weight (LBW) babies. METHODS This was a cross-sectional study of mothers and their newborns from a birth cohort in Aracaju, Northeastern Brazil. Data were collected consecutively from March to July 2005. Information collected included socioeconomic, biological and reproductive aspects of the mothers, using a standardized questionnaire. The impact of early pregnancy on birth weight was evaluated by multiple logistic regression. RESULTS We studied 4,746 pairs of mothers and their babies. Of these, 20.6% were adolescents (< 20 years of age). Adolescent mothers had worse socioeconomic and reproductive conditions and perinatal outcomes when compared to other age groups. Having no prenatal care and smoking during pregnancy were the risk factors associated with low birth weight. Adolescent pregnancy, when linked to marital status "without partner", was associated with an increased proportion of low birth weight babies. CONCLUSIONS Adolescence was a risk factor for LBW only for mothers without partners. Smoking during pregnancy and lack of prenatal care were considered to be independent risk factors for LBW.
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Veloso HJF, Silva AAMD, Barbieri MA, Goldani MZ, Lamy Filho F, Simões VMF, Batista RFL, Alves MTSSBE, Bettiol H. Secular trends in the rate of low birth weight in Brazilian State Capitals in the period 1996 to 2010. CAD SAUDE PUBLICA 2013; 29:91-101. [PMID: 23370028 DOI: 10.1590/s0102-311x2013000100011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 08/30/2012] [Indexed: 05/27/2023] Open
Abstract
Secular trends in rates of low birth weight in Brazilian state capital cities were evaluated for the period 1996 to 2010 using joinpoint regression models. The rates were calculated using data from the Live Births Information System. Newborns weighing less than 500 g were excluded. Only data for capital cities was included since under-registration of births in these cities is lower and new trends can be detected earlier. There was a significant increase in the rate of low birth weight in the Brazilian capitals of the North Region, Northeast Region, South Region and Southeast Region up to 2003/2004, stabilizing thereafter. In the capitals of the Center-west Region the rate increased throughout the whole study period. The rate of low birth weight was higher in the capitals of the more developed regions. The rate of multiple births increased significantly in all Brazilian capitals, while the stillbirth rate decreased and showed a negative correlation with the rate of low birth weight. The increase in the rate of low birth weight may be partially explained by the increase in multiple births, an increase in the birth of infants weighing 500 to 999 g and by the reduction in the stillbirth rate.
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Cetlin AA, Gutierrez MR, Bettiol H, Barbieri MA, Vianna EO. Influence of asthma definition on the asthma-obesity relationship. BMC Public Health 2012; 12:844. [PMID: 23035704 PMCID: PMC3491029 DOI: 10.1186/1471-2458-12-844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 09/27/2012] [Indexed: 11/24/2022] Open
Abstract
Background Epidemiological studies suggest an association between obesity and asthma in adults and children. Asthma diagnosis criteria are different among studies. The aim of this study was to test the influence of asthma definition on the asthma-obesity relationship. Methods In a cross-sectional analysis of 1922 men and women, subjects completed a translated questionnaire from the European Community Respiratory Health Survey and underwent spirometry and a bronchial challenge test. Weight, height and waist circumference were measured. Multiple logistic regression analysis was carried out to assess the association of variables related to obesity and asthma. Asthma was defined either by the presence of symptoms with bronchial hyperresponsiveness (BHR) or by a self-report of a physician-made diagnosis. The following variables were separately tested for associations with asthma: socioeconomic characteristics, schooling, physical activity, smoking status, anthropometry and spirometry. Results No association was detected between asthma confirmed by BHR and obesity indicators, odds ratio (OR) = 1.08 (95% confidence interval: 0.69 - 1.68) for obesity assessed by body mass index ≥ 30 kg/m2; OR = 1.02 (0.74 - 1.40) for obesity assessed by abnormal waist-to-height ratio; and, OR = 0.96 (0.69 - 1.33) for abnormal waist circumference. On the contrary, a previous diagnosis of asthma was associated with obesity, OR = 1.48 (1.01 - 2.16) for body mass index ≥ 30 kg/m2; OR = 1.48 (1.13 - 1.93) for abnormal waist-to-height ratio; and, OR = 1.32 (1.00 – 1.75) for abnormal waist circumference. Female gender, schooling ≥ 12 years and smoking were associated with BHR-confirmed asthma. Physically inactive subjects were associated with a previous diagnosis of asthma. Conclusions Our findings indicate that the relationship between asthma and obesity in epidemiological studies depends on the definition adopted. Certain components of asthma, for instance, symptoms may be more prone to the obesity influence than other ones, like bronchial hyperresponsiveness.
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Affiliation(s)
- Andrea Antunes Cetlin
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Silva AAM, Santos CJN, Amigo H, Barbieri MA, Bustos P, Bettiol H, Rona RJ. Birth weight, current body mass index, and insulin sensitivity and secretion in young adults in two Latin American populations. Nutr Metab Cardiovasc Dis 2012; 22:533-539. [PMID: 21543197 DOI: 10.1016/j.numecd.2010.09.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 08/18/2010] [Accepted: 09/30/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS Although studies have shown association of birth weight (BW) and adult body mass index (BMI) with insulin sensitivity in adults, there is limited evidence that BW is associated with insulin secretion. We assessed the associations between BW and current BMI with insulin sensitivity and secretion in young Latin American adults. METHODS AND RESULTS Two birth cohorts, one from Ribeirao Preto, Brazil, based on 1984 participants aged 23-25 years, and another from Limache, Chile, based on 965 participants aged 22-28 years were studied. Weight and height at birth, and current fasting plasma glucose and insulin levels were measured. Insulin sensitivity (HOMA%S) and secretion (HOMA%β) were estimated using the Homeostatic Model Assessment (HOMA2). Multiple linear regression analyses were carried out to test the associations between BW and adult BMI z-scores on log HOMA%S and log HOMA%β. BW z-score was associated with HOMA%S in the two populations and HOMA%β in Ribeirao Preto when adult BMI z-score was included in the model. BW z-score was associated with decreasing insulin secretion even without adjusting for adult BMI, but only in Ribeirao Preto. BMI z-score was associated with low HOMA%S and high HOMA%β. No interactions between BW and BMI z-scores on insulin sensitivity were shown. CONCLUSIONS This study supports the finding that BW may affect insulin sensitivity and secretion in young adults. The effect size of BW on insulin status is small in comparison to current BMI.
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Affiliation(s)
- A A M Silva
- Department of Public Health, Federal University of Maranhao, 65075630 Sao Luis, Brazil.
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